Background: Antibiotics targeted against C. difficile bacteria are necessary, but insufficient, to achieve a durable clinical response because they have no effect on C. difficile spores that germinate within a disrupted microbiome. ECOSPOR-III evaluated SER-109, an investigational, biologically-derived microbiome therapeutic of purified Firmicute spores for treatment of recurrent CDI. Methods: Adults ≥18 years with recurrent [...]

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: 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: 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: Urinary catheters, vascular catheters, and wounds such as pressure injuries are often hidden from view under gowns and sheets – out of sight, out of mind – contributing to prolonged catheter use, infections, delayed interventions, and diagnostic errors for symptoms (e.g., fever, delirium) related to catheters and wounds. We developed and pilot tested a [...]

Background: Patients admitted to New Hanover Regional Medical Center with a history of opiate use disorder (OUD) and serious infections require a median length of stay (LOS) of 33 days and discharge against medical advice (AMA) 26% of the time, resulting in quality and safety gaps which includes incomplete treatment, readmissions, and high cost of [...]

Background: Skin, soft tissue, and joint infections are common in pediatric patients and can require invasive procedures to drain purulent fluid. Atypical pathogens (fungal and acid-fast bacilli [AFB]) are important but rare causes of these infections with reported case rates as low as 0.6-1.6 cases/100,000 a year. Despite the rarity of these infections, costly atypical [...]

Background: Hospital Onset Clostridium difficile infection (HOCDI) is one of the most common causes of hospital acquired diarrhea. As per a recent study, the mean healthcare costs attributable to primary Clostridium difficile infection (CDI) is about $24,205 per patient. This would be a lot more if the patients were to be discharged to skilled nursing [...]