Jonas G Fosselman was admitted from office on 4/1/01 for infected L THR. Aspiration demonstrated purulent material, and he was started on Ceftriaxone per ID consult recs. with MIC to both PCN and Ceftriaxone pending. MRI of pelvis completed 10/10/01 as pre-op eval. TU Cardiology was consulted for pre-op clearance given extensive H/O cardiomyopathy and unstentable CAD per last cardiac cath 8/7. On further d/w PT, he was adament about being allowed to be D/C home on Abx for August holiday. Given that his clinical picture was much improved on antibiotics, both Dr Salkeld and ID MD agreed to this on provision that he return immediately for any evidence of progressing infection. His R hip pain and exam were much improved by time of discharge. Will plan for IV lon line to be placed prior to D/C for home dosing of QD Ceftriaxone. ID to be re-consulted on admission post-op 10/5 for re-eval of abx choice. By that time it is presumed that the MIC for PCN/CTX will be available for ascertation of proper long-term Abx care. Discharge medications included TYLENOL (ACETAMINOPHEN) 650 MG PO Q4H PRN headache, VENTOLIN (ALBUTEROL INHALER) 1-2 PUFF INH QID PRN sob/wheeze, ECASA (ASPIRIN ENTERIC COATED) 325 MG PO QD, ATENOLOL 25 MG PO QD Food/Drug Interaction Instruction Take consistently with meals or on empty stomach., CEFTRIAXONE 2,000 MG IV QD (Number of Doses Required (approximate): 2), COLACE (DOCUSATE SODIUM) 100 MG PO BID, ENALAPRIL (ENALAPRIL MALEATE) 2.5 MG PO QD, PERCOCET 1-2 TAB PO Q4H PRN pain, ZOCOR (SIMVASTATIN) 5 MG PO QHS Food/Drug Interaction Instruction Avoid grapefruit unless MD instructs otherwise., ISOSORBIDE MONONITRATE 30 MG PO QD Food/Drug Interaction Instruction Give on an empty stomach (give 1hr before or 2hr after food) (Number of Doses Required (approximate): 15), and NEXIUM (ESOMEPRAZOLE) 20 MG PO QD. Discharge instructions included IV Abx, D/C home with services for QD CTX dosing, IV long line placement, re-admission for removal of infected hardware and spacer placement 9/24/01, and IV Ceftriaxone per VNA 2 Gr IV QD for 10/9/01. Return immediately for increasing temps/shaking chills/pain at R hip. Discharge condition was stable. Follow-up appointment(s) included Dr Lobato 9/24/01, VH pre-admit for OR I&D/removal hardware. 9/24/01 scheduled, and Return to Work after eval by Dr Ashurst. Allergy: Shellfish, Morph
antibiotics
Given that his clinical picture was much improved on antibiotics,