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:   Congestive heart failure (CHF) and pneumonia are amongst the leading causes of hospitalization in the United States.  Although a growing number of hospitals use both teaching and nonteaching hospitalist services for patient care, the differences in clinical outcomes and efficiency between these two services is not clearly known. The aim of this study [...]

Background: Advancements in technology have expanded accessibility to telemetry via remote monitoring and resulted in increased application in hospitalized patients. The American Heart Association (AHA) telemetry guidelines restrict use to patients with sepsis, severe electrolyte disturbances or primary cardiac conditions. Respiratory infections have emerged as a common source of hospitalization and telemetry is frequently applied [...]

Background: CMS and other entities have focused on reduction of readmissions as a national quality improvement goal. The 30-day risk standardized readmission rate is derived from administrative data and requires the accurate coding of a principal diagnosis. We sought to validate the coded principal diagnosis for patients admitted with pneumonia and to determine if local [...]

Background: The 2011 the updated IDSA guideline on Community Acquired Pneumonia (CAP) in children recommends a blood culture in children with moderate to severe bacterial CAP requiring hospitalization.  This recommendation was included in the Seattle Children’s Hospital (SCH) Clinical Standard Work (CSW) CAP pathway, for several reasons: (1) blood culture results would drive treatment decisions, [...]

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: An 80 year-old man presented with one day of confusion, worsened cough, and subjective fevers. He had a productive cough since emigrating from Mexico six months ago, but no complaints of dyspnea. He had a history of diabetes and stable angina for the past year. On presentation, he was tachycardic with a temperature [...]

Case Presentation: Klebsiella Pneumoniae is a gram-negative bacterium known to cause pneumonia and urinary tract infections. The hypermucoviscosity phenotype of K. pneumoniae is commonly tested for using the string test. Clinical studies have shown an association between the hypermucoviscosity phenotype and a highly virulent tissue abscess syndrome, causing liver abscesses, endophthalmitis and septic thrombophlebitis. Most [...]