Background. The optimal therapy for critically ill patients with Clostridium difficile infection (CDI) is not known. We aimed to evaluate mortality among CDI who received oral vancomycin (monotherapy) vs intravenous (IV) metronidazole (combination therapy).

The financial impact of an antimicrobial stewardship program in operation for more than 11 years was determined by calculating the reduction expenditures minus labor costs. Depending on method inflation adjustment used, associated with average cost savings $920,070 to $2,064,441 per year.

Abstract Background On Jan 31, 2023, ABNA replaced universal mupirocin nasal decolonization in pts admitted to the burn service. The purpose of this study was evaluate impact with vs on infection rates and antimicrobial utilization pt population.Table 1.Baseline Characteristics Methods This a single-center, retrospective, cohort analysis adults ≥ 18 yrs age an academic medical center service from Feb 2022 - Sept (mupirocin cohort) 2023 (ABNA who received 1 dose or ABNA. Pts were excluded if...

Abstract Background Antibiotic (abx) inertia is when inpatient providers continue inappropriate empiric abx started in the emergency department (ED) rather than changing to an appropriate regimen. Studies using hypothetical case scenarios estimate that this occurs 39% of cases, but phenomenon has not been studied actual prescribing data. The objective study evaluate real-world clinical practice. Methods This retrospective chart review adult inpatients at 885-bed tertiary care referral center...

Abstract Background At this institution on June 30, 2022, universal nasal decolonization with mupirocin ointment was replaced by MRSA PCR assay screening at ICU admission to capture colonization and direct decolonization. The aim of study evaluate the impact duration vanc for suspected PNA in adults admitted TICU.Table 1.Baseline Treatment Characteristics Methods This single-center, retrospective cohort compared pts from Jan - Jun 2022 (pre cohort) 2023 (post cohort). Pts ≥ 18 years age TICU...

Background: Ventilator-associated pneumonia (VAP) is a frequent complication in injured patients. Multiplex polymerase chain reaction (PCR) facilitates rapid identification of many respiratory pathogens prior to formal culture results. Our objective was evaluate the effect multiplex PCR implementation trauma intensive care unit (TICU) on antibiotic utilization and de-escalation. Patients Methods: Injured adult patients admitted TICU with quantitative cultures were included. dichotomized into...

To evaluate the clinical impact of BioFire FilmArray Pneumonia Panel (PNA panel) in critically ill patients.Single-center, preintervention and postintervention retrospective cohort study.Tertiary-care academic medical center.Adult ICU patients.Patients with quantitative bacterial cultures obtained by bronchoalveolar lavage or tracheal aspirate either before (January-March 2021, period) after 2022, implementation PNA panel were randomly screened until 25 patients per study month (75 each...

Expanding antimicrobial resistance patterns in the face of stagnant growth novel antibiotic production underscores importance stewardship which de-escalation remains an integral component. We measured frequency a tertiary care medical center with established program to provide plausible benchmark for de-escalation. A retrospective, observational study was performed by review randomly selected electronic records 240 patients who received simultaneous piperacillin/tazobactam and vancomycin...

(1) Background: Dalbavancin is a long-acting lipoglycopeptide antibiotic approved for skin and soft-tissue infections. Post-marketing experience suggests dalbavancin being used off-label indications that normally require long-term intravenous (IV) antibiotics; however, data assessing this usage are limited. The purpose of study was to evaluate the real-world efficacy, safety, financial impact use. (2) Methods: This retrospective, observational conducted within 4-hospital health system. Adult...

Journal Article Pharmacist involvement in a multidisciplinary initiative to reduce sepsis-related mortality Get access James R. Beardsley, Pharm.D., BCPS, BCPS Wake Forest Baptist Health, Winston-Salem, NC Address correspondence Dr. Beardsley (jbeardsl@wakehealth.edu). Search for other works by this author on: Oxford Academic Google Scholar Catherine M. Jones, M.D., M.S., M.S. University of Missouri Health Sciences Center, Columbia, MO John Williamson, Jason Chou, Ochsner Medical New...

Antibiotic selection is challenging in patients with severe β-lactam allergy due to declining reliability of alternate antibiotics. Organisms isolated from these may exhibit unique resistance phenotypes. The objective this study was determine which antibiotics or combinations provide adequate empirical therapy for who develop Gram-negative infections at our institution. We further sought the effects risk factors drug on adequacy. A retrospective analysis conducted adult hospitalized...

Background Rapid diagnostic tools have emerged as valuable assets assisting clinicians in decision-making regarding patient management the hospital setting. Our study sought to identify potential impact of BioFire® FilmArray® Pneumonia Panel (FP Panel) (BioFire Diagnostics, Salt Lake City, UT, USA) patients with hospital-acquired pneumonia (HAP). Methods Respiratory samples obtained by bronchoalveolar lavage (BAL) or tracheal aspiration (TA) from ICU a diagnosis HAP were tested FP panel...

The impact of a collaborative, employer-sponsored diabetes management program on glycemic control and other clinical endpoints over 6-12 months is reported.In retrospective, chart-based evaluation, glycosylated hemoglobin (HbA(1c)) related health status indicators were assessed among first-year enrollees in the Healthy Outcome Partnership for Employees (HOPE) with Diabetes Program, an ongoing sponsored by Wake Forest Baptist Health (WFBH) system. services provided pharmacists collaboration...

To reduce prescribing errors occurring on discharge from the hospital, a standardized time-out process was implemented general medicine service at Wake Forest Baptist Medical Center. In process, multidisciplinary care team reviewed patient's medical records together to determine optimal medication regimen. This regimen recorded form and then used develop documents.To evaluate impact of that occur as patients are discharged service.The all during 60-day periods before ("pre-group") after...

Among patients with a history of ESBL infection, uncertainty remains regarding whether all these require ESBL-targeted therapy when presenting subsequent infection. We sought to determine the risks associated infection help inform empiric antibiotic decisions.A retrospective cohort study adult positive index culture for Escherichia coli or Klebsiella pneumoniae (EC/KP) receiving medical care during 2017 was conducted. Risk assessments were performed identify factors caused by ESBL-producing...

Abstract Purpose To assess the accuracy of antibiotic indication documentation provided during order entry and prescriber perceptions requirement to specify indications. Methods Patients who received 1 6 selected antibiotics from May through June 30, 2017, were identified. Records 30 randomly patients each study retrospectively reviewed. The primary endpoint was accuracy, defined as agreement entered with that documented in progress notes at time entry. Secondary endpoints included...

To determine whether a multifaceted initiative resulted in maintained reduction inappropriate treatment of asymptomatic pyuria (ASP) or bacteriuria (ASB) the emergency department (ED).Single-center, retrospective study.Beginning December 2015, series interventions were implemented to decrease ASP ASB ED. Patients discharged from ED August October 2015 (preintervention period), 2016 February 2017 (postintervention period 1), and November 2019 January 2020 2) included if they had and/or...

Background The Association of American Medical Colleges (AAMC) guidelines on the entrustable professional activities (EPAs) expected graduating medical students were recently published. Although perceptions educators, residents and programme directors have been described, voice senior is lacking. Methods A single-institution cross-sectional study was performed. Student collected compared with: (1) national (i.e. 13 newly developed undergraduate EPAs); (2) resident expectations through...

Abstract Purpose To address the intravenous (i.v.) opioid shortage, computer-based alerts and modifications were implemented over 2 phases beginning in August 2017 February 2018, respectively. A study was conducted to assess impact of these interventions on dispenses intermittent doses i.v. opioids during a national shortage. Methods retrospective, single-center, pre- postimplementation compare from September through December (phase 1) March 2018 May 2) with same time periods previous year...

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....

Objective A sepsis protocol including institution-specific antibiotic recommendations based on local susceptibility patterns was implemented at our institution. The purpose of this investigation to determine the impact these adequacy initial empiric therapy in patients with severe admitted intensive care unit. Methods This a single-center, retrospective, observational study conducted medical unit university-affiliated center. Charts identified as having database from November 2004 September...

Abstract Background Clostridium difficile infections (CDI) pose a growing threat to hospitalized patients. This study assesses the impact of changing from nucleic acid amplification test (NAAT) stepwise testing algorithm (STA) by using an enzyme immunoassay (GDH and toxin A/B) confirmatory NAAT confirmation in specific cases. Methods In 885 bed academic medical center 24 month pre-/post design was used assess effect STA for following parameters: rates enterocolitis due C.diff (CDE), NHSN...