Frequently Asked Questions: Colon and Rectal Procedures
Q: Do the antibiotic and VTE measures apply to colon and rectal procedures?
A: Yes, the antibiotic timing and antibiotic discontinuation measures apply to colon and rectal procedures, as does the VTE measure. Please use the ACS-developed work flowsheets to identify included procedures.
Q: Which antibiotics can I use to comply with the antibiotic timing measure?
A: While many of the following antibiotics may not be indicated for use in colon and rectal surgery, all can be used to comply with the measure. The College encourages physicians to review current evidence on antibiotic prophylaxis in colon and rectal procedures.
- Ampicillin/sulbactam
- Aztreonam
- Cefazolin
- Cefmetazole
- Cefotetan
- Cefoxitin
- Cefuroxime
- Ciprofloxacin
- Clindamycin
- Ertapenem
- Gatifloxacin
- Gentamicin
- Levofloxacin
- Metronidazole
- Moxifloxacin
- Neomycin
- Vancomycin
Q: Why are colon and rectal procedures excluded from the antibiotic selection measure?
A: Because the included antibiotic selection measure is limited to first and second generation cephalosporins, colon and rectal procedures could not be included. This is not to say that cephalosporins are not appropriate for colon and rectal cases, but they are NOT the only choice, which excludes colon and rectal cases from the current selection measure. For example, ertapenem (a non-cephalosporin) was recently approved by the Food and Drug Administration for use in colon and rectal cases for antibiotic prophylaxis.
Q: How do I report on the measure related to chemotherapy for Stage III colon cancer patients?
A: The current measure was developed by oncologists for oncologists without surgical input. The measures are not well-designed for surgeons to report. However, surgeons can report on the measures during a follow-up visit that is outside of the global billing period. For more information, please consult the ACS-developed work flowsheet for this measure.
Q: What forms of VTE prophylaxis comply with the VTE measure?
A: The following types of prophylaxis can be used to comply with the performance measure:
- Mechanical Prophylaxis
- Low Molecular Weight Heparin
- Low-Dose Unfractionated Heparin
- Adjusted-Dose Warfarin
- Fondaparinux
Because VTE risk is associated with patient factors in addition to procedural risk, the College encourages physicians to review current guidelines to make the appropriate choice for VTE prophylaxis.
Online July 2, 2007
Frequently Asked Questions (FAQS)
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