Page 94 - JSOM Winter 2025

Weighted score 37 46 40 46 35 42

Stewardship [3] No concerns (1) Moderate concerns (3) Minor concerns (2) Minor concerns (2) Minor concerns (2) Moderate concerns (3)

MDRO (PsA or MRSA) [0] Not reliable (4) Yes, PsA (1) Not reliable (4) Not reliable (4) Not reliable (4) Not reliable (4)

Antimicrobial Coverage B. fragilis Clostridia [0] [1] Not Not reliable reliable (4) (4) Not Not reliable reliable (4) (4) Growing Yes resistance (1) (3) Alt. Yes (2) (1) Not Alt. reliable (2) (4) Yes Yes (1) (1)

MSSA [3] Yes (1) Yes (1) Alt. (2) Alt. (2) Yes (1) Yes (1)

Group A Strep [4] Yes (1) Yes (1) Yes (1) Yes (1) Yes (1) Yes (1)

Clinical experience [2] Combat trauma (1) Combat trauma (1) Combat trauma (1) Combat trauma (1) Combat trauma (1) Combat trauma (1) Note “[x]” in column headers refers to weight of that category in calculating the final Weighted Score; “(x)” within the body of the table refers to the category’s score based on Table 2. Lower weighted
TABLE 4 Characterization of Parenteral Antimicrobial Agents for Point-of-Injury Administration in TCCC

Drug interactions [1] None (1) None (1) None (1) None (1) Precipitates with calcium co-administration (3) Not clinically significant (2)

Half-life [3] 2 h (3) 2 h (3) 3–4.5 h (2) 1 h (4) 5–9 h (1) 4 h (1)

Adverse events [2] Minor reactions <10% of population (1) Minor reactions <10% of population (1) Minor reactions <10% of population (1) Minor reactions <10% of population (1) Minor local reactions (skin tightness / induration) <10% of population via IM admin (1) Minor (i.e. diarrhea) <10% of population (1)

Route (IV/IM) [2] Both (1) Both (1) Both (1) Both (1) Both (1) Both (1)

Infusion time [2] IV push over 3–5 min (1) IV push over 2–5 min (1) IV push over 3–5 min (1) IV push over 3–5 min (1) IV push over 5 min (1) IV push over 5 min (1)

Mixture [2] 2g vial recon with 5mL SWFI (2) 2g vial recon with 10mL SWFI, NS, D5W (3) 2g vial recon with 10mL SWFI, NS, D5W (3) 2g vial recon with 10mL SWFI, NS, D5W (3) 2g vial recon with 7mL SWFI, NS, D5W (2) 1g vial recon with NS or SWFI (4)

$/dose [1] 1.50 (1) 11.00 (2) 26.60 (2) 14.36 (2) 11.40 (2) 165.00 (4) scores are considered more favorable.

Antibiotic Cefazolin Cefepime Cefotetan Cefoxitin Ceftriaxone Ertapenem

92 | JSOM Volume 25, Edition 4 / Winter 2025