Patient was admitted to the Toott Hospital surgery service after undergoing LRYGB and was transferred to the floor from the PACU in stable condition. Pain was controlled and no issues were reported overnight into POD1. The patient had an UGI on POD1 that was negative for obstruction or leak, and was started on a Stage I diet which was tolerated well. The following day the patient was started on a Stage II diet that was tolerated as well, but initially struggled to have adequate intake. The patient was started on ALBUTEROL INHALER 2 PUFF INH QID PRN Shortness of Breath, Wheezing, LANTUS (INSULIN GLARGINE) 60 UNITS SC DAILY, ROXICET ORAL SOLUTION (OXYCODONE+APAP LIQUID) 5-10 MILLILITERS PO Q4H PRN Pain, ZANTAC SYRUP (RANITIDINE HCL SYRUP) 150 MG PO BID, ACTIGALL (URSODIOL) 300 MG PO BID, and LEVAQUIN (LEVOFLOXACIN) 500 MG PO DAILY with instructions to administer iron products a minimum of 2 hours before or after a levofloxacin or ciprofloxacin dose dose, and to cycle (hold 1 hr before to 2 hr after) if on tube feeds, and to take 2 hours before or 2 hours after dairy products. Sugars remained high in 200's during admission and patient was seen by Endocrine service and sugars finally improving with lantus 60 sc hs. The patient also had some difficulties with urination on POD4 and required a foley catheter for about a day, but was d/c'd the AM before she was discharged and urinated without incident. Patient was noted to have a UTI at discharge and was started on three day course of levaquin. The patient was discharged in stable condition, tolerating stage II diet well, ambulating, voiding independently, and with adequate pain control. The patient was given explicit instructions to follow-up in clinic with Dr. Truglia in 1-2 weeks and sent home with VNA for wound checks and close sugar control with instructions to f/u with Leland Bredeson by phone and record fingersticks, and to f/u with her PCP if she has further problems with urination. The patient was also instructed to shower but not bathe, swim or otherwise immerse her incision, not to lift anything heavier than a phone book, not to drive or drink alcohol while taking narcotic pain medication, and to resume all of her home medications, and to call her doctor or go to the nearest emergency room if she has fevers > 101.5 F, vomiting, or increased redness, swelling, or discharge from her incision.
Is there history of use of ciprofloxacin
after a levofloxacin or ciprofloxacin dose dose,