Background: Penicillin discovered in 1928 by Sir Alexander Fleming, beginning of the antibiotic revolution. Penicillin as helped increase average life Span in USA from 47 years to 78.8 years. Beta lactam account to about 40% of total antibiotic use every year. 10% of patients in U.S. report penicillin allergy, but 9 out of 10 patients […]

Background: Penicillin discovered in 1928 by Sir Alexander Fleming, beginning of the antibiotic revolution. Penicillin as helped increase average life Span in USA from 47 years to 78.8 years. Beta lactam account to about 40% of total antibiotic use every year. 10% of patients in U.S. report penicillin allergy, but 9 out of 10 patients […]

Background: Our institution’s rate of hospital acquired Clostridioides difficile (C. diff) infection (CDI) is higher than expected based on documented severity of illness of our patients. The C. diff testing algorithm at our institution utilizes a multi-step approach. It begins with two tests (antigen EIA and toxin A/B EIA). If the results of these two […]

Background: Our institution’s rate of hospital acquired Clostridioides difficile (C. diff) infection (CDI) is higher than expected based on documented severity of illness of our patients. The C. diff testing algorithm at our institution utilizes a multi-step approach. It begins with two tests (antigen EIA and toxin A/B EIA). If the results of these two […]

Background: MRSA osteomyelitis in adults is a challenging disease to treat with a high rate of amputation. Patients often undergo prolonged antibiotic therapy and multiple debridements with varied success. In our study, we examine outcomes in 10 cases of MRSA osteomyelitis.   Methods: We performed a chart review to identify cases of biopsy-proven lower extremity […]

Background: Balancing attending supervision with resident autonomy is intended to ensure patient safety while allowing trainees to gain graduated competency and independence upon completion of residency. ACGME work-hour restrictions have increased attending supervision, but its effect on resident education and autonomy is unclear. In order to better understand the underlying tensions and contributing factors to […]

Background: Nearly half of hospitalized patients with bacteriuria or treated for pneumonia receive unnecessary antibiotics (non-infectious/non-bacterial syndrome, e.g., asymptomatic bacteriuria), excess duration (antibiotics prescribed for longer than necessary), or avoidable fluoroquinolones (safer alternative available) at hospital discharge.1-3 However, it is unknown whether antibiotic overuse at discharge varies between hospitals or is associated with patient outcomes. […]

Background: Chronic obstructive pulmonary disease (COPD) is a major public health problem. The Global Burden of Disease Study has projected that COPD will become the third‐leading cause of death worldwide by 2020. In developed countries, COPD exacerbations account for the greatest burden in the health care system, costing the United States billions of dollars annually. […]

Background: Mentoring relationships among physicians in academic medicine have been implemented to facilitate scholarly productivity, faculty development, and retention. Mentorships have been shown to encourage productive activity (e.g., peer‐reviewed publications), drive career advancement (e.g., faculty promotion), and enhance attitudes toward work (e.g., reduced burnout). Yet few studies have examined mentorships' impact at critical points along […]

Background: Between 2007 and 2015, inpatient fluoroquinolone use declined in U.S. Veterans Affairs (VA) hospitals. Whether fluoroquinolone use at discharge has also declined, in particular since antibiotic stewardship programs became mandated at VA hospitals in 2014, is unknown. Methods: In this retrospective cohort study of hospitalizations with infection between January 1, 2014 and December 31, […]