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: 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: Inpatient antibiotic stewardship programs often use pre-prescription approval (PPA) or prospective audit and feedback (PAF) to reduce fluoroquinolone prescribing. Whether these stewardship strategies targeting inpatient fluoroquinolone use also influence prescribing at discharge is unknown. Therefore, we aimed to evaluate the effect of fluoroquinolone stewardship on discharge fluoroquinolone use in patients with pneumonia or a [...]

Background: The CDC Core Elements of Antibiotic Stewardship recommend that patients initiated on broad-spectrum antibiotics (BSA) undergo antibiotic de-escalation within 48-72 hours based on available culture data. However, adherence with this recommendation in patients with sepsis has not been well studied. We assessed the incidence of, and characteristics associated with, anti-methicillin resistant staphylococcus aureus (MRSA) [...]

Background: Clostridioides difficile infection (CDI) is a common, often nosocomial infection associated with substantial morbidity and mortality. Antibiotics are the most important modifiable risk factor, but empiric antibiotics remain appropriate for many patients with severe acute illness. Which antibiotics minimize the risk of CDI remains an important unanswered question. Because protective equipment and isolation were [...]

Background: Antibiotics are frequently prescribed—and overprescribed—at hospital discharge, leading to adverse-events and patient harm. Antibiotic overuse at discharge varies widely across hospitals, with rates of overuse differing up to 5-fold.(1) Our understanding of what approaches optimize prescribing at discharge is limited. Recently, we published the ROAD (Reducing Overuse of Antibiotics at Discharge) Home Framework which [...]

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: 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: Inpatient antibiotic stewardship programs often use pre-prescription approval (PPA) or prospective audit and feedback (PAF) to reduce fluoroquinolone prescribing. Whether these stewardship strategies targeting inpatient fluoroquinolone use also influence prescribing at discharge is unknown. Therefore, we aimed to evaluate the effect of fluoroquinolone stewardship on discharge fluoroquinolone use in patients with pneumonia or a [...]

Background: The CDC Core Elements of Antibiotic Stewardship recommend that patients initiated on broad-spectrum antibiotics (BSA) undergo antibiotic de-escalation within 48-72 hours based on available culture data. However, adherence with this recommendation in patients with sepsis has not been well studied. We assessed the incidence of, and characteristics associated with, anti-methicillin resistant staphylococcus aureus (MRSA) [...]