A5009860399- Antibiotic Use and Resistance
- Central Venous Catheters and Hemodialysis
- Patient Safety and Medication Errors
- Antibiotics Pharmacokinetics and Efficacy
- Patient Satisfaction in Healthcare
- Pharmaceutical Practices and Patient Outcomes
- Healthcare cost, quality, practices
- Emergency and Acute Care Studies
- Pneumonia and Respiratory Infections
- Infection Control in Healthcare
- COVID-19 Clinical Research Studies
- Sepsis Diagnosis and Treatment
- COVID-19 and healthcare impacts
- Nosocomial Infections in ICU
- Healthcare Technology and Patient Monitoring
- Bacterial Identification and Susceptibility Testing
- Quality and Safety in Healthcare
- HIV/AIDS Research and Interventions
- SARS-CoV-2 detection and testing
- Orthopedic Infections and Treatments
- Geriatric Care and Nursing Homes
- Health Systems, Economic Evaluations, Quality of Life
- Healthcare Policy and Management
- Electronic Health Records Systems
- Clostridium difficile and Clostridium perfringens research
Johns Hopkins University
2016-2025
Johns Hopkins Medicine
2016-2025
TuBerculosis Vaccine Initiative
2024
Agency for Healthcare Research and Quality
2018-2024
National Patient Safety Foundation
2013-2023
Oregon Medical Research Center
2022-2023
Lindsay Unified School District
2022-2023
New York Proton Center
2022-2023
Communities In Schools of Orange County
2022-2023
Manhattan Institute for Policy Research
2023
Abstract A panel of experts was convened by the Infectious Diseases Society America (IDSA) to update 2004 clinical practice guideline on outpatient parenteral antimicrobial therapy (OPAT) [1]. This is intended provide insight for healthcare professionals who prescribe and oversee provision OPAT. It considers various patient features, infusion catheter issues, monitoring questions, stewardship concerns. does not offer recommendations treatment specific infections. The reader referred disease-...
Abstract Background Bacterial infections may complicate viral pneumonias. Recent reports suggest that bacterial co-infection at time of presentation is uncommon in coronavirus disease 2019 (COVID-19); however, estimates were based on microbiology tests alone. We sought to develop and apply consensus definitions, incorporating clinical criteria better understand the rate co-infections antibiotic use COVID-19. Methods A total 1016 adult patients admitted 5 hospitals Johns Hopkins Health System...
Abstract A panel of experts was convened by the Infectious Diseases Society America to update 2004 clinical practice guideline on outpatient parenteral antimicrobial therapy (OPAT) [1]. This is intended provide insight for healthcare professionals who prescribe and oversee provision OPAT. It considers various patient features, infusion catheter issues, monitoring questions, stewardship concerns. does not offer recommendations treatment specific infections. The reader referred disease- or...
To better monitor patients on outpatient parenteral antimicrobial therapy (OPAT), we need an improved understanding of risk factors for and timing OPAT-associated adverse drug events (ADEs).We analyzed a prospective cohort OPAT discharged from 2 academic medical centers. Patients underwent chart abstraction telephone survey. Multivariable analyses estimated adjusted incident rate ratios (aIRR) between clinical demographic clinician-determined clinically significant ADEs. Descriptive data...
Abstract Background Perceived patient demand for antibiotics drives unnecessary antibiotic prescribing in outpatient settings, but little is known about how clinicians experience this or perceived shapes their decision-making. Objective To identify perceive and the way these perceptions stimulate prescribing. Methods Qualitative study using semi-structured interviews with settings who prescribe antibiotics. Interviews were analyzed conventional directed content analysis. Results conducted 25...
Abstract Background Outpatient coronavirus disease 2019 (COVID-19) has been insufficiently characterized. To determine the progression of and determinants hospitalization, we conducted a prospective cohort study. Methods adults with positive reverse transcription polymerase chain reaction results for severe acute respiratory syndrome 2 (SARS-CoV-2) were recruited by phone between April 21 July 23, 2020, after receiving outpatient or emergency department testing within large health network in...
Abstract Background Socially vulnerable patients often complete parenteral antibiotic courses in healthcare facilities due to injection drug use (IDU) history or unstable housing situations, which leads significant personal and health system costs prolonged hospitalization risks. Our aim was assess the potential impact of dalbavancin (DBV) utilization on length stay (LOS) adverse outcomes this patient population. Methods Retrospective study ≥ 18 years old who were followed Johns Hopkins...
Many hospitalized patients with complicated infections are discharged on outpatient parenteral antimicrobial therapy (OPAT). However, little is known about how to improve the postdischarge care of OPAT patients.The impact an infectious diseases transitions service (IDTS) patient readmissions, as well processes care, was evaluated.We performed a controlled, quasi-experimental evaluation over 15 months in academic medical center. Intervention-arm patients, before and after introduction IDTS,...
Clinical decision support (CDS) embedded within the electronic health record (EHR) is a potential antibiotic stewardship strategy for hospitalized patients. Reduction in urine testing and treating asymptomatic bacteriuria (ASB) an important to promote stewardship. We created intervention focused on reducing patients at large tertiary care center. The objective of this study was design reduce unnecessary urinalysis culture (UC) orders as well treatment ASB. performed quasiexperimental among...
Debate about whether certain antimicrobial agents traditionally considered vesicants increase the risk of catheter complications has led to uncertainty in venous placement protocols. To understand patients requiring home-based outpatient parenteral therapy (OPAT) should receive peripheral catheters (e.g., midline catheters) versus central catheters, and place OPAT at higher for complications, we investigated associations between agent(s) complications.
Abstract Background Although outpatient parenteral antimicrobial therapy (OPAT) is generally considered safe, patients are at risk for complications and thus require close monitoring. The purpose of this study to determine how OPAT programs structured United States–based infectious diseases (ID) physicians perceive barriers safe care. Methods We queried members the Emerging Infections Network (EIN) between November December 2018 about practice patterns providing OPAT. Results A total 672 EIN...
<h3>Introduction:</h3> Antibiotic resistance is a public health emergency fueled by inappropriate antibiotic use. Public education campaigns often focus on global or societal harm of misuse. There has been little research into what messages have the greatest impact patient preferences for nonindicated antibiotics in ambulatory clinics. <h3>Methods:</h3> We administered survey at primary care clinic Baltimore, MD. A total 250 participants rated 18 statements about potential from how each...
<h3>Importance</h3> The Agency for Healthcare Research and Quality (AHRQ) Safety Program Improving Antibiotic Use aimed to improve antibiotic prescribing in ambulatory care practices by engaging clinicians staff incorporate stewardship into practice culture, communication, decision-making. Little is known about implementation of practices. <h3>Objective</h3> To examine changes visits during the AHRQ Program. <h3>Design, Setting, Participants</h3> This cohort study evaluated a quality...
To compare the accuracy of linkage to care metrics for patients diagnosed with HIV using retention in and virological suppression as gold standards effective linkage.A retrospective cohort study aged 18 years older newly infection City Philadelphia, 2007-2008.Times from diagnosis clinic visits or laboratory testing were used measures. Outcome variables included being retained achieving suppression, 366-730 days after diagnosis. Positive predictive value (PPV), negative (NPV), area under...
Abstract Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic control will require widespread access to accurate diagnostics. Salivary sampling circumvents swab supply chain bottlenecks, is amenable self-collection, and less likely create an aerosol during collection compared with the nasopharyngeal swab. Methods We real-time reverse-transcription polymerase reaction Abbott m2000 results from matched salivary oral fluid (gingival crevicular collected in Oracol...
Abstract Background Patients increasingly receive home-based outpatient parenteral antimicrobial therapy (OPAT). Understanding which patients might be at higher risk of complications is critical in effectively triaging resources upon and after hospital discharge. Methods A prospective cohort discharged from 1 2 academic medical centers Baltimore, Maryland, between March 2015 December 2018 were consented randomly divided into derivation validation cohorts for development a score adverse OPAT...
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BACKGROUND Patients are frequently discharged with central venous catheters (CVCs) for home infusion therapy. OBJECTIVE To study a prospective cohort of patients receiving therapy to identify environmental and other risk factors complications. DESIGN Prospective between March December 2015. SETTING Home after discharge from academic medical centers. PARTICIPANTS Of 368 eligible 2 hospitals peripherally inserted tunneled CVCs, 222 consented. remained in the until 30 days CVC removal. METHODS...
Medical devices, or instruments tools to manage disease, are increasingly used in the home, yet there have been limited evaluations of how older adults and caregivers safely use these devices. This study concerns a qualitative evaluation (1) barriers facilitators appropriate use, (2) outcomes inappropriate among at transition from hospital home with skilled health care (SHHC). Guided by human factors engineering work system model, authors conducted direct observations contextual inquiry...
Orthopoxvirus-specific T-cell responses were analyzed in 10 patients who had recovered from Mpox including 7 people with human immunodeficiency virus (PWH). Eight participants detectable virus-specific responses, a PWH was not on antiretroviral therapy and immunosuppressive therapy. These 2 robust polyfunctional CD4+ to peptides the 121L vaccinia (VACV) protein. T-cells 4 of 5 HLA-A2-positive targeted at least 1 previously described HLA-A2-restricted VACV epitope, an epitope participants....
Abstract Background Skilled home healthcare (HH) provided in‐person care to older adults during the COVID‐19 pandemic, yet little is known about pandemic's impact on HH transition patterns. We investigated pandemic (1) service volume; (2) population characteristics; and (3) patterns for receiving services after hospital or skilled nursing facility (SNF) discharge. Methods Retrospective, cohort, comparative study of recently hospitalized (≥ 65 years) SNF discharge at two large agencies in...