Background: Clostridioides difficile infection (CDI) can be prevented through infection prevention practices and antibiotic stewardship. We found in a 2013 national survey (571 hospitals, 71% response rate) that while infection prevention practices for CDI were common in U.S. hospitals, only 52% had an antibiotic stewardship program (ASP). On 1 January 2017, The Joint Commission required [...]

Background: In 2011, the Infectious Diseases Society of America (IDSA) published new guidelines on the management of community acquired pneumonia (CAP) in children and recommended use of narrow spectrum antibiotics such as ampicillin or amoxicillin over broader spectrum antibiotics such as ceftriaxone. Many studies have shown that these guidelines have been adopted with varying success [...]

Background: Growing antimicrobial resistance, C. difficile infection and cost have triggered a greater reliance on antimicrobial stewardship. Most stewardship models rely upon a central team, often led by ID specialists, to oversee prescribing in an institution. However, there are limitations to this paradigm. Purpose: We believe opportunities exist for hospitalists to drive stewardship by integrating [...]

Background: Inpatient bedside whiteboards enhance patient-provider communication and satisfaction with care, but little is known about patients’ perspectives on the whiteboards. Our objectives were to understand patients’ views on the usability and design/content of these boards; and assess nursing views on current practice of whiteboard utilization, including barriers and suggestions to optimal use. Methods: We [...]

Background: Most patients hospitalized with community-acquired pneumonia (CAP) can be safely treated with 5-days of antibiotic therapy. However, many are not. We aimed to determine whether a hospitalist-focused collaborative could reduce excessive antibiotic use in patients hospitalized with CAP through a combination of collaboration with antibiotic stewardship, data feedback, pay-for-performance, and sharing best practices. Methods: [...]

Case Presentation: A 54-year old female was hospitalized for 3-week history of abdominal pain, chills, nausea and diarrhea. Her past medical history was significant for multiple self-reported antibiotic allergies, Roux-en-Y gastric bypass complicated by gastrojejunostomy leak, and prior perisplenic abscess requiring percutaneous drainage. On admission, blood pressure was 137/79, heart rate of 80, respirations 20, [...]