Background: Pneumonia is often treated for longer than necessary, yet factors associated with excess duration of treatment are unknown. We sought to: (a) develop an algorithm to determine appropriate antibiotic duration in non-intensive care unit (ICU) patients hospitalized with pneumonia and (b) apply this algorithm to an ongoing prospective study to determine patient-, provider-, and [...]

Background: Pneumonia is often treated for longer than necessary, yet factors associated with excess duration of treatment are unknown. We sought to: (a) develop an algorithm to determine appropriate antibiotic duration in non-intensive care unit (ICU) patients hospitalized with pneumonia and (b) apply this algorithm to an ongoing prospective study to determine patient-, provider-, and [...]

Background: Overuse of urine testing may result in downstream events that impact antibiotic use and hospital length of stay (LOS). The aims of this study were to examine the impact of inpatient urine culture testing on inpatient antibiotic use and hospital length of stay using a national administrative dataset. Methods: We performed a retrospective cohort [...]

Background: Surgical site infections (SSI) can complicate any operative procedure although this risk is mitigated through the use of preoperative antibiotic prophylaxis.  While antibiotic prophylaxis can provide great benefit, inappropriate use can lead to the development of multi-drug resistant organisms causing increased morbidity, mortality, and cost. Although national clinical guidelines for preoperative antibiotics prophylaxis were [...]

Background: Despite detailed Infectious Disease Society of America (IDSA) skin and soft tissue infection guidelines, patients with cellulitis at our institution consistently receive antibiotics with high local resistance or that are inappropriate based on IDSA guidelines. Our baseline data showed that 55 percent of patients receive antibiotics per IDSA guidelines and only 33 percent of [...]

Background: Approximately 1-2% of the U.S. population gets community-acquired pneumonia (CAP) annually in the U.S. and CAP is associated with substantial mortality, morbidity and costs.  While the incidence of CAP is well-defined, the incidence of outpatients who fail antibiotics and eventually become hospitalized is less clear.  The objective of this study was to provide real-world [...]

Background: Inappropriate antibiotic use is associated with bacterial resistance, adverse events, and an increased risk of Clostridium difficileinfection. However, providers often prescribe antibiotics for viral respiratory infections and treat infections such as bacterial pneumonia for unnecessarily prolonged durations.  Serum procalcitonin (PCT)-guided treatment is known to safely reduce antibiotic use and duration of treatment in pneumonia. [...]

Case Presentation: A 55 year old male with past medical history significant for congestive heart failure, severe persistent asthma and eosinophilic pneumonia on chronic prednisone and status post bronchial thermoplasty presented with fever, cough, shortness of breath and chest pain of 2 weeks and hemoptysis of 3 days duration. He also had two recent hospitalizations [...]