<h3>Background</h3> Antibacterial drug use is a major risk factor for bacterial resistance, but little known about antibacterial in US hospitals. The objectives of this study were to characterize trends sample hospitals and identify predictors use. <h3>Methods</h3> We measured systemic from validated claims data at 22 university teaching January 1, 2002, through December 31, 2006, we examined potential including hospital patient demographics stewardship policies. <h3>Results</h3> A total 775...

Many hospital antimicrobial stewardship programs restrict the availability of selected drugs by requiring prior approval. Carbapenems may be among restricted drugs, but it is unclear if hospitals that actually use fewer carbapenems than do not use. Nor clear restriction related to resistance. We evaluated relationship between carbapenem and volume both incidence rate proportion carbapenem-resistant Pseudomonas aeruginosa isolates from 2002 through 2006 in a retrospective, longitudinal,...

Hospital antibiograms are commonly used to help guide empiric antimicrobial treatment and an important component of detecting monitoring trends in resistance. To serve these purposes, must be constructed using standardized methods that allow inter- intrahospital comparisons. Antibiograms include surveillance cultures duplicate bacterial isolates can overestimate rates In 2002, the National Committee for Clinical Laboratory Standards (now known as Institute [CLSI]) published standards...

<h3>Objectives</h3> To estimate the possible relationship between statin use and risk of healthcare facility onset <i>Clostridium difficile</i>. <h3>Methods</h3> Patients over 18 years age admitted to hospitals contributing data University HealthSystem Consortium 2002 2009 were eligible. with ICD-9-CM code 008.45 who received a minimum 3-day course either metronidazole or oral vancomycin on/after day 5 admission considered incident cases <i>C difficile</i> infection. 31 472 infection...

Evidence about the beneficial effects of statins on reducing infections is accumulating. Identifying ways to reduce infection risk in patients with cirrhosis important because increased mortality and costs associated infections.To estimate extent which statin use prolongs time among cirrhosis.We identified Veterans cirrhosis, but without decompensation (n = 19 379) using US Health Administration data from 2001 2009. New users were propensity matched non-users other cholesterol-lowering...

The main objective of this study was to determine patient- and hospital-level medication risk factors associated with Clostridium difficile infection (CDI) occurrence among patients clustered within hospitals using a multilevel model.Patients healthcare-associated (HA)-CDI were identified from 64 academic medical centres in 2009. A frequency match conducted; for each case, up two controls selected, matched on similar pre-infection length stay clinical service line. Patient- use, including...

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The International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code for Clostridium difficile infection (CDI) is used surveillance CDI. However, the ICD-9-CM alone cannot separate nosocomial cases from acquired outside institution. purpose this study was to determine whether combining with medication treatment data CDI in hospitalized patients could enable us distinguish between and who were admitted primary objective compare sensitivity, specificity,...

Trends in pediatric antibacterial use were examined 20 academic health centers during the period 2002-2007. There was a significant increase of linezolid (P < .001) and macrolides = decrease aminoglycosides first-generation cephalosporins .001).

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To assess the economic impact of Clostridium difficile infection (CDI) in a large multihospital cohort.Retrospective case-control study.Administrative claims data from 45 academic medical centers.A total 10,857 patients who developed health care-associated CDI and were discharged between April 1, 2002, March 31, 2007 (cases); each case patient was matched by hospital, age, quarter year hospital discharge, diagnosis related group to at least one control did not develop (19,214...

Abstract Background The Centers for Medicare and Medicaid Services (CMS) implemented a core measure sepsis (SEP-1) bundle in 2015. One element was initiation of broad-spectrum antibiotics within 3 hours diagnosis. policy has the potential to increase antibiotic use Clostridioides difficile infection (CDI). We evaluated impact SEP-1 implementation on CDI occurrence rates. Methods Monthly adult data 4 categories (surgical prophylaxis, community-acquired infections,...

Study Objective. To measure diversity (or heterogeneity) of antibiotic use in a sample hospitals the United States and to assess an association with bacterial resistance. Design. Observational cross‐sectional study. Setting. Forty‐two general medical‐surgical hospitals, mostly Eastern States. Data Source. Administrative claims data hospital antibiograms during 2003. Measurements Main Results. Antibiotic was measured by defined daily dose (DDD), assessed using Simpson's Index Shannon‐Weiner...

Study Objectives. To evaluate hepatic cytochrome P450 (CYP) 3A4 activity in patients infected with the human immunodeficiency virus (HIV) using erythromycin breath test (ERMBT), and to examine relationship of ERMBT plasma concentrations indinavir nelfinavir. Design. Prospective observational study. Setting. University infectious diseases clinic. Subjects. Thirty‐nine HIV‐positive 47 healthy controls. Intervention. After controls, 25 received or Measurements Main Results. Compared variability...

Use of antifungal agents and predictors total use among adult inpatients at U.S. academic health centers was characterized.Claims data obtained from a geographically representative sample nonprofit were analyzed to characterize systemic antifungals during the period 2004-08. Aggregate identify trends in three classes (azoles, polyenes, echinocandins), as well individual agents. Multivariate regression analysis employed investigate interhospital variability use.Aggregate included increased...

Abstract Objectives To determine whether an antimicrobial stewardship ‘intensity’ score predicts hospital usage. Methods An for 44 academic medical centres was developed that comprised two main categories: resources (antimicrobial programme personnel and automated surveillance software) strategies (preauthorization, audit with intervention feedback, education, guidelines clinical pathways, parenteral to oral therapy programmes, de-escalation of therapy, order forms dose optimization)....

Purpose. The implementation and evaluation of vancomycin nomogram guidelines in a computerized prescriber-order-entry (CPOE) system are described. Methods. Initial orders for patients over age 18 years who received between August 1 September 30, 2006 (preimplementation), March April 2007 (postimplementation), were compared with recommendations to determine if the regimen ordered coincided recommendation. numbers changes serum concentrations measured during first five days therapy also...

Study Objectives To determine the proportion of hospitalized adults with hospital‐onset C lostridium difficile infection ( CDI ) who continued to receive concomitant non‐CDI antibacterial agents, characterize therapy that these patients received before and after diagnosis CDI, compare hospital outcomes between those did not have their previous discontinued diagnosis. Design Retrospective cohort study. Data Source Drug use administrative discharge data from 42 United States academic medical...