The comparative efficacy of ceftazidime-avibactam and meropenem-vaborbactam for treatment carbapenem-resistant Enterobacteriaceae (CRE) infections remains unknown. This was a multicenter, retrospective cohort study adults with CRE who received or ≥72 hours from February 2015 to October 2018. Patients localized urinary tract infection repeat drug exposures after the first episode were excluded. primary endpoint clinical success compared between groups. Secondary endpoints included 30- 90-day...

ABSTRACT Implementation of the Verigene Gram-positive blood culture test led to reductions in time acceptable antibiotic overall (1.9 versus 13.2 h, respectively; P = 0.04) and appropriate for patients with vancomycin-resistant Enterococcus (4.2 43.7 h; 0.006) viridans group Streptococcus (0.2 7.1 0.02).

Data on the effectiveness of definitive oral (PO) antibiotics for BSIs in preparation discharge from hospital are lacking, particularly Gram-positive bacterial (GP-BSI). The objective this study was to determine rates treatment failure based bioavailability PO antimicrobial agents used GP-BSI.This a single-center, retrospective cohort adult inpatients admitted an academic medical center over three-year period. Patients with non-staphylococcal GP-BSI who received intravenous and were then...

Emerging infectious diseases challenge healthcare systems to implement new models of care. We aim evaluate the rapid implementation a care model for monkeypox in our health system.This is retrospective case series evaluation under Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework testing large, integrated system.Atrium Health implemented education providers, protocols, management potential cases using electronic record (EHR) data capabilities, telehealth,...

Several national organizations have advocated for inpatient antiretroviral stewardship to prevent the consequences of medication-related errors. This study aimed evaluate impact a initiative on outcomes in people with HIV (PWH).A pharmacist-led audit and review adult patients admitted an ICD-10 code was implemented existing antimicrobial program. A quasi-experimental, retrospective cohort conducted comparing PWH during pre- post-intervention periods. Rates therapy (ART)-related errors...

Acute bacterial skin and structure infections (ABSSSI) are a leading cause of hospitalization, but often treated inappropriately in the inpatient setting. A multifaceted stewardship intervention was implemented to encourage prescribing guideline-concordant therapy (GCT).To examine impact this initiative on antimicrobial practices patient outcomes.This single-center, retrospective study adult inpatients admitted with primary or secondary diagnosis ABSSSI, classified by type severity based...

Abstract The approval of letermovir provided a new option for cytomegalovirus (CMV) prophylaxis in CMV seropositive allogeneic hematopoietic stem cell transplantation (allo‐HSCT) recipients. Data are limited on the use treatment infection. We performed single‐center retrospective review allo‐HSCT recipients who received off‐label infection (CMV DNAemia and disease) from November 2017 until 2019. Fifteen patients were included, 14 which DNAemia. median duration transplant to was 41 days...

Abstract Background Options for treatment of carbapenem-resistant Enterobacteriaceae (CRE) infections were historically limited to antibiotics with efficacy and significant toxicities. Ceftazidime/avibactam (CA) meropenem/vaborbactam (MV) are superior older regimens; however, a direct comparison the agents is lacking. This study compared clinical outcomes including recurrence infection emergence drug resistance in patients who received CA vs. MV CRE infections. Methods was multicenter,...

Abstract Background Treatment of HIV is recommended as soon possible and early initiation combined antiretroviral therapy (cART) associated with improved engagement in care; however, treatment cART often deferred hospitalized patients despite being correlated outcomes. We implemented an institutional intervention to ensure all people living (PLwH) were on during hospitalization improve patient Methods prospectively identified PLwH at our institution had ID physicians pharmacists they...

Abstract Background Handshake stewardship has displayed promise in engaging providers the pediatric population but literature adults are lacking. Face-to-face interactions proposed to improve antibiotic (ASP) efforts challenging services that have low ASP acceptance and commonly utilize broad-spectrum antibiotics (BSA) such as Hepato-Pancreato-Biliary surgical (HPBSS). Methods was initiated by Antimicrobial Support Network (ASN) with HPBSS at Carolinas Medical Center January 2019. In-person...

Infections caused by carbapenem resistant Enterobacteriaceae (CRE) are associated with high mortality. Optimal treatment for CRE bacteremia remains unclear, including the role of combination therapy, carbapenem-containing regimens, or newer antimicrobials, such as ceftazidime-avibactam (CAZ-AVI). The objective this study was to evaluate risk factors mortality in patients bacteremia, a focus on antimicrobial therapy. This multicenter, retrospective cohort inpatients within Carolinas...

Acute bacterial skin and structure infections (ABSSSI) are a leading cause of hospitalization; however, ABSSSI often treated inappropriately in the inpatient setting. A multifaceted stewardship intervention was implemented at large health care system to encourage guideline-concordant (GC) antibiotic prescribing. Components included development clinical pathway, computerized order set, provider education. The objective this study examine impact initiative on antimicrobial prescribing...

Antimicrobial stewardship is an important strategic initiative to ensure patient safety and antimicrobial efficacy. National guidelines advocate the utilization of clinical pathways as effective strategies enhance appropriate selection treatment regimens. This article reviews 3 algorithms using risk stratification techniques implemented within our organization: acute bacterial skin structure infections, febrile neutropenia, Clostridium difficile infection. The relevant literature surrounding...

Inappropriate antimicrobial use is one of the key contributors in increase resistance facing clinicians today. Incomplete documentation or assessment medication allergies can play a significant role inappropriate utilization antimicrobials. It reported that 10% to 30% patients have an allergy 1 more antimicrobials.1 The most common antimicrobials penicillin (PCN), with rate 15% hospitalized labeled as PCN allergic.2 In study 198 primary care providers within academic medical center treating...

Clostridium difficile infection (CDI) presents a significant burden to the US health care system, leading 29,000 deaths and $4.8 billion in excess costs annually.1C. was most commonly reported pathogen recent multistate prevalence survey of care–associated infections, with rates per 1000 discharges on rise.2,3C. affects patients variety settings, including hospitals, nursing homes, community.1 Hence, CDI has now been identified as an urgent threat by Centers for Disease Control Prevention,...

Abstract Background Transition from intravenous (IV) to oral (PO) antibiotics is common practice in patients with Gram-positive bloodstream infections (GP-BSI); however, clinical data evaluating IV PO switch options are lacking. The objective of this study was examine effectiveness for definitive treatment GP-BSI, a focus on bioavailability (BA). Methods This single-center, retrospective cohort adult inpatients admitted an 874-bed academic medical center Charlotte, NC between September 1,...

Abstract Background Complexity of antiretroviral therapy (ART) for human immunodeficiency virus (HIV) and lack experience with treatment regimens by providers may lead to medication-related errors (MRE). Consequences MRE include loss virologic suppression, development ART resistance, HIV transmission, increased morbidity mortality. The purpose this study was compare ART-related linkage care through consultation Infectious Diseases (ID) as a result ID-pharmacist review. Methods An ID...

Abstract Background Echinocandins (ECH) are recommended first-line for initial therapy (IT) of candidemia (CD) over fluconazole (FLU) due to their broad spectrum activity. This recommendation was made prior widespread implementation rapid diagnostic testing (RDT), allowing prompt species identification and targeted therapy. The objective this study compare clinical outcomes in patients with CD caused by FLU-susceptible who received either FLU or ECH as IT. Methods a multicenter,...

Abstract Background Recent studies have suggested that combination therapy may be preferred to monotherapy for select patients with methicillin-resistant Staphylococcus aureus bacteremia (MRSA-B); however, direct comparison between various regimens is lacking. Methods This was a multicenter, retrospective cohort study evaluating adult MRSA-B who received vancomycin/ceftaroline (VAN+CPT) or daptomycin/ceftaroline (DAP+CPT) at least 48 hours April 1, 2017 and June 30, 2019. Patients primary...

Abstract Background Background:: Immune modulation in patients with clinical features suggestive of a cytokine release syndrome (CRS) has become pharmacologic target for potential treatment COVID-19 and prevention ARDS. Tocilizumab is an IL-6 receptor blocker FDA-approved chimeric antigen (CAR) T cell-induced severe or life-threatening CRS. The objective this study was to describe outcomes associated tocilizumab compared those not receiving critically ill COVID-19. Methods Methods:...

Abstract Background Cidofovir (CDV) dosing is based on limited clinical evidence and varies by indication. The optimal dose to achieve a virologic response has not been established. Routine lab monitoring, renal adjustments, co-administration with intravenous (IV) fluids probenecid are recommended limit CDV-associated nephrotoxicity but lack standard approach. Methods This was retrospective evaluation of patients admitted Atrium Health’s Carolinas Medical Center or Levine Children’s Hospital...