A5055429379- Antibiotic Use and Resistance
- Pneumonia and Respiratory Infections
- Pneumocystis jirovecii pneumonia detection and treatment
- Bacterial Identification and Susceptibility Testing
- Hepatitis B Virus Studies
- HIV/AIDS Research and Interventions
- Pharmaceutical studies and practices
- Hepatitis C virus research
- Antibiotics Pharmacokinetics and Efficacy
- COVID-19 Clinical Research Studies
- HIV/AIDS drug development and treatment
- Antibiotic Resistance in Bacteria
- HIV Research and Treatment
- Antimicrobial Resistance in Staphylococcus
- HIV-related health complications and treatments
- Emergency and Acute Care Studies
- Patient Satisfaction in Healthcare
- Respiratory viral infections research
- SARS-CoV-2 and COVID-19 Research
- Hepatitis Viruses Studies and Epidemiology
- Long-Term Effects of COVID-19
- Electronic Health Records Systems
- Herpesvirus Infections and Treatments
- Pharmacovigilance and Adverse Drug Reactions
- Streptococcal Infections and Treatments
Cleveland Clinic
2016-2025
Biology of Infection
2017
Engineering Associates (United States)
2017
Abstract Background Community-acquired pneumonia (CAP) is a leading cause of hospital admissions and antimicrobial use. Clinical practice guidelines recommend switching from intravenous (IV) to oral antibiotics once patients are clinically stable. Methods We conducted retrospective cohort study adults admitted with CAP initially treated IV at 642 US hospitals 2010 through 2015. Switching was defined as discontinuation initiation without interrupting therapy. Patients switched by day 3 were...
Abstract Background Community-acquired pneumonia (CAP) is a leading cause of hospitalizations and mortality in the US. Studies have reported racial disparities various infectious syndromes, but race not known to be associated with antimicrobial resistance. Limited data exist on differences CAP treatment inpatient setting. The aim this study was assess impact racial/ethnic prescribing habits hospitalized patients CAP. Methods This retrospective cohort 10,224 assessed associations between...
Abstract Background Methicillin-resistant Staphylococcus aureus (MRSA) is an important yet uncommon cause of inpatient community-acquired pneumonia (CAP). While the American Thoracic Society/Infectious Diseases Society America (ATS/IDSA) guidelines recommend rapid MRSA nasal screening to guide anti-MRSA antibiotic (abx) therapy when CAP suspected, guideline adherence and its impact on abx use unclear. We aimed assess prevalence effect de-escalation in inpatients with CAP. Methods This...
Abstract Background The practice of outpatient parenteral antimicrobial therapy (OPAT) has challenges such as reduced control and monitoring in the setting. Lack availability OPAT lab is associated with poorer outcomes. This study sought to describe operations practices an program within a large health system identify clinical operational opportunities for workflow improvement. Laboratory completion over proportion courses Methods was retrospective cohort patients receiving healthcare from...
OBJECTIVE To describe the impact of rapid diagnostic microarray technology and antimicrobial stewardship for patients with Gram-positive blood cultures. DESIGN Retrospective pre-intervention/post-intervention study. SETTING A 1,200-bed academic medical center. PATIENTS Inpatients cultures positive Staphylococcus aureus , Enterococcus faecalis E. faecium Streptococcus pneumoniae S. pyogenes agalactiae anginosus spp., Listeria monocytogenes during 6 months before after implementation Verigene...
The majority of antimicrobial use occurs in the ambulatory setting. Antimicrobial stewardship programs (ASPs) are effective improving appropriate prescribing and now required by accreditation bodies.This was a cross-sectional, multicenter survey describing current state ASPs national cohort Vizient member hospitals with healthcare settings serves as benchmark for strategies related to program effectiveness.One hundred twenty-nine responses from variety institution types across 44 states were...
Respiratory viral polymerase chain reaction (RV PCR) tests assist in rapidly identifying pathogens and differentiating versus bacterial causes of pneumonia. Studies evaluating the use RV PCR on antibiotic adults have demonstrated mixed results. We implemented an antimicrobial stewardship (ASP) intervention for patients with a positive test result who were receiving broad-spectrum antibiotics aimed to assess impact usage.Retrospective quasi-experimental study adult hospitalized comparing time...
Objective. Evaluate antimicrobial stewardship interventions targeted to reduce highly active antiretroviral therapy (HAART)– or opportunistic infection (Ol)–related medication errors and increase error resolution. Design. Retrospective before-after study. Setting. Academic medical center. Patients. Inpatients who were prescribed before the intervention (January 1, 2011, October 31, 2011) after (July 2012, December 2012). Patients treated with lamivudine tenofovir monotherapy for hepatitis B...
Background: Centers for Disease Control and Prevention recommends 3 months of once-weekly rifapentine/isoniazid (3HP) latent tuberculosis infection (LTBI) treatment given by directly observed therapy (DOT) or self-administered (SAT) in patients ≥2 years old. 3HP has been associated with increased incidence hepatic, gastrointestinal, flu-like, cutaneous adverse drug reactions (ADRs) compared isoniazid monotherapy. Objective: This study evaluated completion rates tolerability LTBI a real-world...
Bamlanivimab and casirivimab-imdevimab are novel virus-neutralizing monoclonal antibodies authorized to treat mild moderate COVID-19 in outpatients at risk for progression severe disease. Treatment early the disease may show efficacy reducing disease, although safety data limited. They not hospitalized patients with more advanced
Background: Information technology, including clinical decision support systems (CDSS), have an increasingly important and growing role in identifying opportunities for antimicrobial stewardship-related interventions. Objective: The aim of this study was to describe compare types outcomes CDSS-built stewardship alerts. Methods: Fifteen alerts were evaluated the initial program (ASP) review. Preimplementation, reviewed retrospectively. Postimplementation, real-time. Data collection included...
The immunomodulators tocilizumab and baricitinib improve outcomes in severely ill patients with coronavirus disease 2019 (COVID-19); however, comparative analyses of clinical related to these agents are lacking. A national shortage shifted treatment critically patients, allowing for an outcome comparison a similar population. purpose this study is compare COVID-19 who received those baricitinib.
Background Ceftolozane/tazobactam is currently Food and Drug Administration–approved for the treatment of complicated intra-abdominal urinary tract infections; however, it often used in clinical practice nosocomial pneumonia, particularly due to Pseudomonas aeruginosa. Previous data this area are limited small case studies. Methods This was a retrospective series all patients receiving ceftolozane/tazobactam variety infectious indications at large academic medical center. Results There were...
Immunization rates in pre-liver transplant patients have been historically below for immunocompetent patients. At Cleveland Clinic, an infectious diseases (ID) consult is required all during the liver evaluation and may beneficially impact vaccination rates. The goal of this study was to evaluate pre-transplant candidates. This single-center, retrospective chart review included adults transplanted between January 1, 2013, December 31, 2016. Prior transplant, and/or documented seropositivity...
Summary It is unclear if the prophylaxis dose of 300 mg/day sufficient for achieving serum concentrations targeting treatment invasive fungal infections. To evaluate differences between PCZ in patients receiving DRT vs OS and higher doses than , a retrospective review was conducted on inpatients who received either or prophylaxis. Baseline demographics including comorbid conditions, indication therapy were collected. Serum trough collected at steady state. Fifty‐seven during study period. A...
Abstract Key points In a multicenter point-prevalence study, we found that the rate of supportive care was high; among those receiving COVID-19 drug therapies, adverse reactions occurred in 12% patients. Purpose There are currently no FDA-approved medications for treatment coronavirus disease 2019 (COVID-19). At onset pandemic, off-label medication use supported by limited or clinical data. We sought to characterize experimental therapies and identify safety signals during this period....
Vaccine preventable diseases can affect solid organ transplant recipients post-transplant. Therefore, the administration of vaccines and assessment serologic response should be prioritized in pre-transplant period.This single-center, retrospective study included 349 adult heart or lung candidates between December 1, 2017 November 30, 2019. We describe vaccination status for hepatitis A, B, tetanus, pneumococcal, influenza, other recommended vaccinations among candidates.Eighty-two (91%) 77...
Abstract Background Community-acquired pneumonia (CAP) is a significant public health concern and leading cause of hospitalization inpatient antimicrobial use in the USA. However, determining etiologic pathogen challenging because traditional culture methods are slow insensitive, to prolonged empiric therapy with extended-spectrum antibiotics (ESA) that contributes increased hospital length stay, resistance. Two potential ways reduce exposure ESA (a) rapid diagnostic assays can provide...