Background: Community acquired pneumonia (CAP) is commonly treated in hospitals and frequently results in antibiotic overuse. Important areas of overuse for CAP include excess treatment duration and unnecessary fluoroquinolone use. Smaller hospitals, including critical access hospitals (CAHs), often have limited resources for antibiotic stewardship compared to larger institutions which impedes stewardship efforts. After 2 years [...]

Background: Dichotomous outcomes—such as mortality—rarely capture the range of potential outcomes important to patients and clinicians. To address this limitation, the Desirability of Outcome Ranking (DOOR) score was created to rank potential outcomes from least to most desirable. Currently, there is no standardized method to develop a DOOR score and data are limited on whether [...]

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: In 2022, healthcare spending in the US accounted for 17.3% of its GDP(1), yet the US ranked near the bottom among high-income nations for key health outcomes. It is unclear if a similar relationship exists between spending and health outcomes across US Hospitals. Centers for Medicare and Medicaid Services (CMS) reports a standardized risk-adjusted [...]

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 [...]

Case Presentation: A 78-year-old man with a history of paraplegia secondary to spinal stenosis, who presented with worsening dyspnea, fatigue, and confusion. On presentation, he was tachypneic and hypoxic, requiring 4 liters of oxygen via nasal cannula.Initial imaging revealed a large left pleural effusion with significant left lung atelectasis, a moderate right pleural effusion, and [...]

Case Presentation: A 70-year-old male with a past medical history notable for HFrEF, CAD, hypertension, hyperlipidemia, CKD, and CHRF presented to an outside emergency department with a two-month history of unintentional weight loss, nausea, and worsening lower abdominal pain radiating to the back. CT angiogram showed abnormal soft tissue enhancement around the infrarenal abdominal aorta. [...]

Case Presentation: Acute eosinophilic pneumonia (AEP) is a rare condition and is often idiopathic, but among drug-induced causes, daptomycin-associated AEP is the most common.[1] The patient is a 75-year-old female with a past medical history of Sheehan syndrome, adrenal insufficiency, hypothyroidism, and type two diabetes mellitus admitted to the hospital with a non-productive cough ongoing [...]

Case Presentation: A 61-year-old, non-smoking, white female with history of Coronavirus disease 2019 (COVID-19) twice, and long COVID syndrome, presented with progressively worsening dyspnea over the last five months. She was repeatedly diagnosed with pneumonia and treated with antibiotics and steroids without relief prior to hospital presentation. Workup in the hospital revealed neutrophilic leukocytosis, but [...]

Case Presentation: A 39-year-old Hispanic female, with no significant past medical history presented with complaints of fever, chills, myalgia, and cough ongoing for the past 10 days. The patient had a heart rate of 143 beats per minute, a Temperature of 103.4° F, and a respiratory rate of 33. The patient had a WBC count [...]