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: Third International Consensus Definitions for Sepsis and Septic Shock (SEP-3) defines Sepsis as life-threatening organ dysfunction due to a dysregulated host response to infection. In United States about 1.5 million Americans are diagnosed with Sepsis each year and about 250,000 of them die each year. It is also the costliest single diagnosis to treat [...]

Background: Increased Emergency Department (ED) boarding has been linked to worse patient outcomes, including delays in treatment (Jiraporn et al 2014), increased length of stay (Singer et al 2011), and increased mortality (Singer et al 2011; Sun et al 2013). Patients who meet time zero (T-0) for diagnosis with severe sepsis while boarding in the [...]

Background: Overuse of urine testing may result in downstream events that impact antibiotic use and hospital length of stay (LOS). The aims of this study were to examine the impact of inpatient urine culture testing on inpatient antibiotic use and hospital length of stay using a national administrative dataset. Methods: We performed a retrospective cohort [...]

Background: Sepsis, which is life-threatening organ dysfunction occurring in response to systemic infection, is a frequently fatal syndrome for which early recognition and treatment are paramount. While there are some reports that female and black patients with sepsis experience greater delays in time to antibiotics, there is an overall paucity of published data on whether [...]

Background: Timely identification and treatment are integral to sepsis management in emergency department (ED) and inpatient settings. Increasingly, automated alerts embedded in electronic health records (EHRs) are used to expedite sepsis detection but may lead to false alarms and increased alarm fatigue. Additionally, recent data have demonstrated that the EPIC Sepsis Model—a proprietary sepsis alert [...]

Background: Infants ≤ 60 days of age with a urinary tract infection (UTI) are a challenging population. Without clear guidelines for management, there is variability in renal imaging and antibiotic use. Our study examined patterns of renal imaging and antibiotic use in infants ≤ 60 days of age with UTI at a tertiary care children’s [...]

Background: Community acquired pneumonia (CAP) is one of the leading causes of hospitalization in the United States.[1] In an effort to improve the quality of care for this resource-intensive disease, our institution implemented a clinical decision support (CDS) pathway for CAP comprised of three phases: (1) education on best practices, (2) education and a CDS [...]

Background: Spontaneous Bacterial Peritonitis (SBP) is associated with high mortality.  A recent article[1] showed that, in the setting of SBP, delayed paracentesis was associated with increased mortality.  Because of the clinical ramifications of this association, we attempted to recreate this finding using our local patient population. Methods: Similar to the study that prompted this inquiry, [...]

Background: Sepsis is one of the most common causes for adult emergency department admissions and carries high morbidity and mortality. Appropriate and timely administration of intravenous (IV) antibiotics is one of the cornerstones of initial management of sepsis. Indeed, mortality has been shown to increase by 7-14% for each hour of delay in antibiotic administration. [...]