Background: Urgency of and time to antibiotic administration has often been highlighted to prevent complications of community acquired pneumonia (CAP). Adult literature is mixed on whether administration of antibiotics within four hours of diagnosis of CAP reduces morbidity and mortality, however this has not been studied in pediatric patients. We evaluated whether time to antibiotics [...]

Background: Early administration of antimicrobials is one of the most effective interventions to reduce sepsis mortality. Despite this, delays in antibiotic initiation occur, particularly in patients presenting without hypotension. We sought to understand patient characteristics and presenting symptoms associated with antibiotic delays in this population. Methods: Cohort study of adult patients hospitalized with community-onset sepsis [...]

Background: Community acquired pneumonia (CAP) is a leading cause of hospitalization, economic burden and excess antibiotic use in the United States.1,2 Previously, a multidisciplinary group at University of Utah Health launched a clinical decision support triggered CAP pathway in 2017 that was associated with cost savings and decreased duration of antibiotics.3 Based on review of [...]

Background: Hospital antibiotic stewardship programs (ASPs) play a critical role in minimizing unnecessary antibiotic use and combating antimicrobial resistance. Although various antibiotic stewardship interventions have been described, the feasibility and sustainability of these approaches remain uncertain. Furthermore, some interventions may be challenging for smaller hospitals to implement due to informatics resource limitations. Thus, we aimed [...]

Case Presentation: A 26-year-old male with HbSS sickle cell disease and a history of recurrent hospitalizations for vaso-occlusive crises, requiring a right chest port for pain management and IV fluids, presented with sepsis and an acute vaso-occlusive crisis. Initial infectious workup, including chest X-ray, CT of the chest, abdomen, and pelvis, and urinalysis, was unremarkable. [...]

Case Presentation: A 64-year-old male with a history of idiopathic portal vein hypertension requiring splenectomy at age four, COPD, and treated lung cancer presented with dyspnea and anorexia. Clinical examination revealed tachypnea, tachycardia, dry cough, cachexia, and dry skin. CT scans showed bilateral pulmonary opacities and confirmed asplenia. He was admitted to the intensive care [...]

Case Presentation: A 60-year-old male with a past medical history of hypertension, hyperlipidemia, and diabetes mellitus presented to the emergency department with a progressive lower extremity rash, abdominal discomfort, and diarrhea. The patient was hospitalized five days prior for lower extremity cellulitis and was discharged on clindamycin. After discharge, he developed a bilateral lower extremity [...]

Case Presentation: A 58-year-old man from Thailand presented to the emergency department with a one month history of night sweats, penile pain, swelling, and scrotal wound drainage. Five months prior, he had traveled to India for a semi-rigid penile implant. After a diagnosis of “urethral tuberculosis” in Thailand, he began RIPE therapy (rifampin, isoniazid/pyridoxine, pyrazinamide, [...]

Case Presentation: An 86-year-old female with advanced dementia presented with a four-day history of worsening encephalopathy and jaundice with associated severely poor oral intake. The patient had progressive weakness, increased work of breathing, and vague abdominal pain. The initial exam demonstrated lower abdominal tenderness to palpation with guarding. She was admitted for septic shock requiring [...]

Case Presentation: We present a case of symptomatic meropenem induced cholestasis in a 57 year old male with insulin dependent diabetes complicated by polymicrobial foot ulcers that required multiple toe amputations. He presented with chief complaints of fatigue, decreased appetite, and weight loss. He was septic on arrival and was found to have wet gangrene [...]