A5086156889- Urinary Tract Infections Management
- Antibiotic Use and Resistance
- Antibiotics Pharmacokinetics and Efficacy
- Hemodynamic Monitoring and Therapy
- Anesthesia and Pain Management
- Primary Care and Health Outcomes
- Heart Failure Treatment and Management
- Patient Satisfaction in Healthcare
- Sepsis Diagnosis and Treatment
- Intramuscular injections and effects
- Health and Medical Studies
- Central Venous Catheters and Hemodialysis
- Pediatric Urology and Nephrology Studies
- Bacterial Identification and Susceptibility Testing
- Orthopedic Infections and Treatments
- Pharmaceutical studies and practices
Duke University Hospital
2019-2025
Duke Medical Center
2018-2021
Abstract Background Urinary tract infections (UTIs) constitute 3 million emergency department visits (ED) annually and 15% of outpatient antibiotic prescriptions. The setting is the highest volume antimicrobial prescribing in United States, however, generally a neglected practice area for stewardship (AS) programs. This study sought to evaluate need AS with an existing ED feedback system ambulatory patients. Primary Outcome Methods multi-center, retrospective included adults > 18...
Urinary tract infections (UTIs) are often misdiagnosed or treated with exceedingly broad-spectrum antibiotics, leading to negative downstream effects. We aimed implement antimicrobial stewardship (AS) strategies targeting UTI prescribing in the emergency department (ED).We conducted a quasi-experimental prospective AS intervention outlining appropriate diagnosis and management across 3 EDs, within an academic 2 community hospitals, North Carolina, United States. The study was divided into...
Outpatient Parenteral Antibiotic Therapy (OPAT) provides coordinated services to deliver parenteral antibiotics outside of the acute care setting. However, reduction in monitoring and supervision may impact risks readmission hospital. While identifying those at greatest risk hospital through use computer decision support systems could aid its prevention, validation such tools this patient population is lacking.The primary aim study determine ability electronic health record-embedded EPIC...
Abstract Background Urinary tract infections (UTIs) are the most common outpatient indication for antibiotics and an important target antimicrobial stewardship (AS) activities. With The Joint Commission standards now requiring AS, data supporting effective strategies needed. Methods We conducted a 2-phase, prospective, quasi-experimental study to estimate effect of AS intervention on guideline-concordant antibiotic prescribing in primary care (PC) clinic urgent (UC) between August 2017 July...
Abstract Objectives Outpatient parenteral antimicrobial therapy (OPAT) is associated with high hospital readmission rates. A 30 day unplanned risk prediction model for OPAT patients has been developed in the UK. Given significant differences patient mix and methods of delivery, we explored its utility Duke University Health System (DUHS) receiving OPAT. Methods We analysed episodes adult from two hospitals between 1 July 2019 February 2020. The discriminative ability to predict all-cause...
Abstract Background Despite recent literature supporting non-inferiority of oral therapy, many patients are treated with traditional extended intravenous (IV) antimicrobial courses. The objective this study was to evaluate the attitudes infectious disease (ID) specialists on utilizing antimicrobials (PO-A) for treatment bone and joint infections (BJI). Methods This a multicenter clinician survey ID from 1/10/23 – 1/31/23, regarding their attitude towards using PO-A BJIs. Survey respondents...
Abstract Background In response to rising inpatient costs, health care systems are investigating mechanisms avoid unnecessary admissions and reduce length of stay. Outpatient parenteral antimicrobial therapy (OPAT) provides a pathway for patients receive intravenous antimicrobials at home or in skilled nursing facility (SNF); however, admission is often required OPAT initiation. Our interdisciplinary team developed process initiate directly from our infectious diseases (ID) clinic (Figure...
Urinary tract infections (UTIs) are the most common outpatient indication for antibiotics and an excellent target antimicrobial stewardship (AS) interventions. This study evaluated impact of education data feedback on UTI diagnosis prescribing. A clinic-specific antibiogram, treatment guideline, educational session were provided at one urgent care (UC) primary (PC) clinic in Durham, NC August November 2017. Educators reviewed appropriate diagnosis, treatment, duration therapy UTIs, including...
Abstract Background Achieving lasting, sustainable effects in outpatient AS interventions has been a challenge for many programs. Our group observed an initial benefit of intervention focused on diagnosis and management urinary tract infections (UTIs). However, prescribing habits trended back toward baseline over time. This study aimed to evaluate the impact routine education comparative data feedback durability UTIs. Methods We conducted prospective quasi-experimental at one primary care...
Abstract Background Broad spectrum antibiotics are often prescribed to patients presenting the emergency department (ED) for evaluation of urinary tract infection and pyelonephritis (UTI). We evaluated effect a target-specific antibiogram, education, feedback on UTI diagnosis antibiotic prescribing in this setting. Methods created urine-specific antibiogram from seen treated without admission at three ED locations (one academic two community hospitals). then provided treatment algorithm...
Abstract Background Outpatient parenteral antimicrobial therapy (OPAT) is used for patients that require prolonged durations of intravenous (IV) antimicrobials and who are healthy enough to receive the medications in outpatient setting. While OPAT both efficacious cost-effective, hospital readmission rates high. Durojaiye colleagues UK developed a 30-day unplanned risk prediction model patients. Given differences patient mix methods delivery, we validated established assessment Duke...