A5112893567- Antibiotic Use and Resistance
- Bacterial Identification and Susceptibility Testing
- HIV/AIDS drug development and treatment
- Streptococcal Infections and Treatments
- Pneumonia and Respiratory Infections
- Antimicrobial Resistance in Staphylococcus
- COVID-19 Clinical Research Studies
- Sepsis Diagnosis and Treatment
- Hepatitis C virus research
- Pharmaceutical studies and practices
- Drug-Induced Adverse Reactions
- Pharmacovigilance and Adverse Drug Reactions
- Neonatal and Maternal Infections
- Patient Satisfaction in Healthcare
- Respiratory and Cough-Related Research
- Innovations in Medical Education
- SARS-CoV-2 and COVID-19 Research
- Antibiotics Pharmacokinetics and Efficacy
- Hematological disorders and diagnostics
- Kawasaki Disease and Coronary Complications
- Mechanical Circulatory Support Devices
- Pharmacological Effects and Toxicity Studies
- Child and Adolescent Health
- COVID-19 Impact on Reproduction
- Orthopedic Infections and Treatments
Children's Hospital Colorado
2018-2024
University of Colorado Denver
2017-2024
University of Colorado Anschutz Medical Campus
2014-2024
University of Colorado System
2023
American Association of Nurse Practitioners
2022
Colorado School of Public Health
2021
Denver Health Medical Center
2021
University of Montana
2013-2019
Although coronavirus disease 2019 (COVID-19) is mild in nearly all children, a small proportion of pediatric patients develop severe or critical illness. Guidance therefore needed regarding use agents with potential activity against acute respiratory syndrome 2 pediatrics.
Abstract Background Although coronavirus disease 2019 (COVID-19) is a mild infection in most children, small proportion develop severe or critical illness. Data describing agents with potential antiviral activity continue to expand such that updated guidance needed regarding use of these children. Methods A panel pediatric infectious diseases physicians and pharmacists from 20 geographically diverse North American institutions was convened. Through series teleconferences web-based surveys,...
In March 2020, the White House Coronavirus Task Force determined that clinicians in United States needed expert treatment guidelines to optimally manage patients with COVID-19, a potentially life-threatening disease caused by new pathogen for which no specific treatments were known be effective.
Children's Hospital Colorado created a unique method of antimicrobial stewardship, called handshake that effectively decreased hospital anti-infective use and costs in its pilot year (2013). Handshake stewardship is distinguished by: (1) the lack prior authorization; (2) review all prescribed anti-infectives; (3) shared by physician pharmacist; (4) daily, rounding-based, in-person approach to supporting providers. We sought reevaluate outcomes program after 5 years experience, totaling 8...
In November 2020, the US Food and Drug Administration (FDA) provided Emergency Use Authorizations (EUA) for 2 novel virus-neutralizing monoclonal antibody therapies, bamlanivimab REGN-COV2 (casirivimab plus imdevimab), treatment of mild to moderate coronavirus disease 2019 (COVID-19) in adolescents adults specified high-risk groups. This has challenged clinicians determine best approach use these products.A panel experts pediatric infectious diseases, diseases pharmacy, intensive care...
Abstract Background Letermovir (LTV), an antiviral with exclusive activity against Cytomegalovirus (CMV), is approved for prophylaxis of CMV infection and disease in adult hematopoietic cell transplant (HCT) patients. The use LTV the pediatric HCT population off‐label, has limited literature to support its use. Procedure This was a single‐center, retrospective, matched (1:1 LTV:non‐LTV) cohort study allogeneic recipients transplanted at Children's Hospital Colorado from 2015 2022. primary...
Historically, acute hepatitis C virus (HCV) infection was treated with shorter durations of interferon-containing therapies. In the era direct-acting antivirals (DAAs), it is unclear whether efficacy treatment achieved in chronic can be maintained abbreviated courses therapy during phase.The sofosbuvir-containing regimens without interferon for HCV HIV-1 infected individuals (SWIFT-C) an open-label, 2-cohort clinical trial which first cohort assessed safety and 12 weeks sofosbuvir plus...
To compare initial treatment with intravenous immunoglobulin (IVIG) versus IVIG plus infliximab in multisystem inflammatory syndrome children (MIS-C).Single-center retrospective cohort study of patients MIS-C who met Centers for Disease Control and Prevention criteria received from April 2020 to February 2021. Patients were included compared on the basis therapy either alone or infliximab. The primary outcome was need additional 24 hours more after initiation.Seventy-two inclusion criteria....
Penicillin allergy is reported in up to 10% of the general population; however, >90% patients reporting an are tolerant. Patients labeled as penicillin allergic have longer hospital stays, increased exposure suboptimal antibiotics, and risk methicillin-resistant Staphylococcus aureus Clostridioides difficile. The primary aim with our quality improvement initiative was increase delabeling at least among all hospitalized pediatric a efforts directed toward determined be low for true...
Abstract This article provides a focused update to the clinical practice guideline on treatment and management of patients with COVID-19, developed by Infectious Diseases Society America. The panel presents recommendation use vilobelimab in hospitalized adults critical COVID-19. is based evidence derived from systematic literature review adheres standardized methodology for rating certainty strength according GRADE (Grading Recommendations, Assessment, Development, Evaluation) approach.
OBJECTIVES Initiation and continuation of empirical antimicrobial agents for a 48–72-hour observation period is routine practice in the diagnosis treatment infants children with concern bacteremia. We examined blood cultures at freestanding pediatric hospital over 6-year to determine time positivity. METHODS Data were extracted all patients who hospitalized had drawn between January 2013 December 2018. Time positivity was calculated on basis date culture collected compared growth first...
In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon possible after acceptance. Accepted have been peer-reviewed and copyedited, but are posted before technical formatting author proofing. These not final version record will be replaced with article (formatted per style proofed by authors) at a later time.
The nucleotide analogues tenofovir and sofosbuvir are considered to have low potential for drug interactions.To determine the effect of sofosbuvir-based HCV treatment on plasma concentrations cellular diphosphate.HIV-infected participants with acute were treated 12 weeks + ribavirin in Cohort 1 or 8 ledipasvir/sofosbuvir 2 AIDS Clinical Trials Group study 5327. Only taking disoproxil fumarate included this analysis. Tenofovir plasma, diphosphate dried blood spots PBMCs measured pre-HCV...
There is a paucity of data on dosing continuous infusion vancomycin (CIV) in pediatric patients, despite it being an attractive treatment option for limiting escalating doses intermittent vancomycin. The purpose this study was to determine the total daily dose CIV required attain therapeutic serum concentrations (SVCs) patients according age (≥31 days <2 years, 2 <8 and 8 <18 years).We retrospectively evaluated who were transitioned from between January 2013 December 2016. Demographic data,...
Metronidazole is traditionally dosed every 6-8 hours even though in adults it has a long half-life, concentration-dependent killing, and 3-hour postantibiotic effect. Based on this logic, some pediatric hospitals adopted once-daily dosing for appendicitis, despite limited pharmacokinetics-pharmacodynamics (PK/PD) children. We studied patients with appendicitis given metronidazole once daily to determine whether would meet target area under the curve (AUC)/minimum inhibitory concentration...
Intracellular tenofovir diphosphate concentrations are markedly increased in HIV/HCV coinfected individuals receiving disoproxil fumarate (TDF) with sofosbuvir-containing treatment. Sofosbuvir may inhibit the hydrolysis of TDF to tenofovir, resulting or monoester forms, which augment cell loading. We sought quantify and without ledipasvir/sofosbuvir.HIV/HCV participants TDF-based therapy were sampled pre-dose 1 4 h post-dose prior weeks after initiating ledipasvir/sofosbuvir. Tenofovir was...
Few studies describe the impact of antimicrobial stewardship programs (ASPs) on recognizing and preventing diagnostic errors. Handshake (HS-ASP) is a novel ASP model that prospectively reviews hospital-wide usage with recommendations made in person to treatment teams. The purpose this study was determine if HS-ASP could identify intervene potential errors for children hospitalized at quaternary care children's hospital.Previously self-identified "Great Catch" (GC) interventions by Children's...
BACKGROUND: Acute hematogenous musculoskeletal infections are a common cause of hospitalization in children. A locally developed clinical care guideline (CCG) for acute was implemented at our quaternary pediatric hospital July 2012. The purpose this study to evaluate the long-term sustainability previously described improvements after CCG implementation. METHODS: Clinical outcomes children hospitalized with Children’s Hospital Colorado from June 2009 through September 2018 were...
Summary: Invasive fungal infections are a significant cause of morbidity and mortality in children with immunodeficiencies. Current dosing recommendations for voriconazole often result subtherapeutic exposure pediatric patients. In this single-center retrospective study, we reviewed hospitalized patients receiving at least one inpatient serum trough concentration measured. Patient characteristics courses associated concentrations were summarized all as well grouped by age (0 to 1 y, 2 11 12...
While Streptococcus pneumoniae (Spn) is the leading cause of pediatric complicated community acquired pneumonia (cCAP), it infrequently recovered by culture-based methods. We studied real-world clinical impact an Spn PCR assay for pleural fluid.