Background: Hospital at home (HaH) programs have shown efficacy as substitutes for high-cost, traditional hospitalization in patients who are primarily low-acuity and with a range of medical conditions, including community-acquired pneumonia (CAP) and urinary tract infection (UTI). However, wide-spread adoption is minimal as providers and patients are challenged to consider HaH at the time of [...]

Background: Pneumonia is a major health concern despite advances in preventive measures including vaccinations. In the United States, Pneumonia is one of the most common cause of hospital admissions other than child birth. One million adults seek care in a hospital due to pneumonia every year with nearly 5% succumb to Pneumonia(1). We sought to [...]

Background: Legionella pneumophilia is typically transmitted via inhalation aerosols derived from water or soil during outbreaks or be acquired sporadically, commonly causing community-acquired or nosocomial pneumonia1,2. Death occurs through progressive respiratory failure, shock and multiorgan failure3,4. Epidemiological data for in-patient Legionella in the United States (U.S.) is lacking. The objective of the study is 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: Identification of pathogens causing community-acquired pneumonia (CAP) in hospitalized patients has improved with the utilization of nasopharyngeal (NP) polymerase chain reaction (PCR). Literature shows that 20-25% of pathogens are identified when using urine antigens, sputum and blood cultures, and can improve up to 70% when adding NP PCR for viruses, Staphylococcus aureus and Streptococcus [...]

Background: Pneumocystis jirovecii pneumonia (PJP) is an opportunistic infection associated with lymphopenic conditions including HIV/AIDS, hematologic malignancy1, organ transplantation2, and lymphocyte-suppressive therapies such as high dose glucocorticoids3,4. PJP prophylaxis, which is highly effective, is indicated when the incidence of PJP exceeds the rate of adverse events due to prophylaxis.4,7 Guidelines from the American Thoracic Society [...]

Background: In an effort to improve the design of future noninferiority studies, the endpoints for registrational trials of antimicrobials for the treatment of community-acquired bacterial pneumonia (CABP) were recently updated [1]. Lefamulin (LEF) is a first-in-class systemic pleuromutilin antibiotic newly approved for the treatment of adults with CABP [2]. The efficacy of LEF was demonstrated [...]

Background: Asthma, bronchiolitis, and pneumonia are common pediatric inpatient diagnoses. Viral testing (VT) is not routinely necessary for these diagnoses as it often does not impact management. Our study objectives for each diagnosis are to; 1) describe trends in VT over the last 5 years including seasonal variation (respiratory season- Oct-March versus non-respiratory season- April-Sept), [...]

Case Presentation: A 33-year-old woman presented to the hospital following seven days of persistent fever and non-productive cough despite a course of azithromycin prescribed by her primary care physician. She denied shortness of breath, chest pain, palpitations or lower extremity swelling. She reported no sick contacts or travel in the last six months. She endorsed [...]

Case Presentation: A 59-year-old female presented to the emergency department with a 5-day history of cough, chest pain, shortness of breath, and fever. She also reported nausea, vomiting, right upper quadrant abdominal pain and arthralgia. She denied any headaches. Past medical history was remarkable for gallstones. On physical exam, she appeared in moderate distress, was [...]