• Pharmacy will autosubstitute Qualaquin 324 mg for all quinine orders as it is the only product on the market.
• Pharmacy will place a copy of the P&T review which contains the FDA News letter on the chart of all patients with orders for quinine for one month.
• Pharmacy will NOT leave hand written notes to physicians recommending that quinine should not be used for treatment of leg cramps.

 Note: Quinine is the levorotary isomer of qunidine

Doxycycline and nitrofurantoin  are recommended for susceptible VRE lower urinary tract infections. Nitrofurantoin is contraindicated if creatinine clearnance is less than 60 ml/min.

Linezolid is recommended for treatment of documented serious vancomycin resistant Enterococcus faecium infections when no other alternative is available.

Linezolid is not recommended for treatment of other documented infections unless the patient is allergic/intolerant to all other antibiotics demonstrating activity against the pathogen.

·      Synercid’s predominate ADRs are infusion site related, including pain, inflammation, edema and thrombophlebitis, occurring in 75% of patients when Synercid was given through a peripheral line.  Infusion related ADRs are dose and concentration dependent.  Approximately 5% of patients have discontinued Syncercid due to infusion site reactions.  Central line infusion is preferred. Arthralgias and myalgias are common and may be severe.  Other ADRs include HA, GI disturbances, non-local skin reactions, and LFT and bilirubin elevations up to 5 times the upper limit of normal.