Pine Box Warning

I had to give a pine box warning to one of our pharmacists last night. The patient had a deep rapidly spreading infection and was allergic to penicillin and all cephalosporins. The infection appeared to be gas forming and we needed to jump on it in a hurry. He had already failed Flagyl. I wrote to get him started on 900 mg of cleocin every 8 hours asap and made arrangements to go to the OR. When the patient got to pre-op, he still had not received his cleocin. I called the pharmacy to see what was up and immediately was told that it had to be appoved by the pharmacy supervisor on call because cleocin had a black box warning. After I told them that I didnt give a ***it and that I wanted it now, I asked them what was the "lack box warning" It turns out that it can lead to C. difficile diarhea. I told them that I hope they do get diahrhea, that means that they will still be alive! Right now there is a Pine Box Warning, without it, they will be dead!

I got the cleocin and the patient did ok. Anerobic infections are no fun. Anyway the head of the pharmacy called me and apoligized for the delay. She told me that from the administratosphere and edict came out that to decrease complications that may lead to extended stays in the hospital (CMS) unfunded and possible litigation issues, they had instituted this Black Box Warning policy!