Background: Approximately 5-10% of the US population reports a Penicillin (PCN) allergy. Only 1 in 10 of these patients are found to have a positive reaction to PCN. This label comes at a grave cost, with higher incidences of multidrug-resistant nosocomial infections reported among these patients. With the lack of novel antibiotics and the alarming [...]

Background: Approximately 5-10% of the US population reports a Penicillin (PCN) allergy. Only 1 in 10 of these patients are found to have a positive reaction to PCN. This label comes at a grave cost, with higher incidences of multidrug-resistant nosocomial infections reported among these patients. With the lack of novel antibiotics and the alarming [...]

Background: Drug induced long QT syndrome is quite common in daily clinical practice but its impact is unknown. Methods: We searched the PubMed and EMBASE databases (until May 2nd, 2017) to identify studies reporting drug induced Long QT syndrome and followed the PRISMA guidelines. The main outcomes measured in these studies were QTc prolongation, Ventricular [...]

Background: The hands of hospitalists are often the source for transmitting multidrug resistant organisms (MDROs), and as such are the target of numerous hand hygiene interventions. Despite this focus, the prevalence of various MDROs on healthcare personnel (HCP) hands during routine patient care has not been well established. Therefore, we conducted a systematic review to: [...]

Background: Warfarin is commonly used in long-term anticoagulation and has a narrow therapeutic index. Dosing is dependent on intrinsic patient variables including cytochrome P450 2C9 (CYP2C9) and VKORC1 polymorphisms. High protein binding and CYP-dependent clearance mechanisms of NSAIDs also affect warfarin serum levels. This study investigates the observed pharmacologic interaction of concurrent NSAID and warfarin [...]

Background: Medication alerts are one of the touted safety features with the electronic health record (EHR). With time, users tend to override the alerts, which leads to patient harm. The phenomenon of “alert fatigue” is well known to any practicing clinician. Frequent interruptions of little value train physicians to disregard alerts in favor of efficiency. [...]

Case Presentation: This is the case of an ex-41 2/7 week baby girl, born to a 28 year old G4P0 now 1 mother via cesarean section for arrest of descent. Early in pregnancy, the mother endorsed occasional marijuana use and had one urine toxicology screen positive for marijuana. Subsequent urine drug screens were all negative, [...]

Case Presentation: A 49 year-old man with a recent diagnosis of myasthenia gravis presented with 3 days of fever up to 103, rhinorrhea, frontal headache, mild lower extremity weakness, a mildly productive cough, and a leukocytosis to 16. As he had been started on prednisone and azathioprine 10 days prior to his presentation, he underwent [...]

Case Presentation: A 69-year-old woman with metastatic breast cancer, atrial fibrillation (on coumadin) and CKD stage III was admitted after a fall. She was treated for pneumonia with ceftriaxone and azithromycin. On hospital day 2, the patient became encephalopathic, hypotensive and required endotracheal intubation for hypercapneic respiratory failure. Antibiotics were broadened to vancomycin and piperacillin/tazobactam.On [...]

Case Presentation: Anti-thyroid Drugs (ATD) such as propilthiourcil (PTU) and methimazole (MTM) can cause a number of systemic changes such as fever, rash, and respiratory symptoms (from epistaxis to diffuse alveolar hemorrhage). Guidelines almost always recommend MTM over PTU because it has fewer side effects. We present a patient diagnosed with Grave’s Disease who developed [...]