Antibiotic Treatment for 7 versus 14 Days in Patients with Bloodstream Infections | NEJM
Bloodstream infections are associated with substantial morbidity and mortality. Early, appropriate antibiotic therapy is important, but the duration of treatment is uncertain. In a multicenter, non...
Health Economic Evaluation of Antimicrobial Stewardship, Procalcitonin Testing, and Rapid Blood Culture Identification in Sepsis Care: A 90-Day Model-Based, Cost-Utility Analysis - PubMed
Our bundled intervention of ASP, PCT, and BCID among adult critically ill patients with sepsis was potentially cost-effective, but with substantial decision uncertainty.
7-Day Antibiotic Regimen Found Noninferior to 14-Day Treatment for Bloodstream Infections
The BALANCE trial suggests that shorter treatment durations may reduce healthcare costs, antibiotic exposure, and antimicrobial resistance risk, providing an alternative for critically ill patients.
Clinical decision support in the electronic health record: a primer for antimicrobial stewards and infection preventionists: work smarter so end users don't work harder - PubMed
By outlining a structured approach for the development and evaluation of CDS interventions, with focus on end user engagement, efficiency and feasibility, ASP and IP professionals can leverage CDS to enhance IP/ASP quality improvement initiatives aimed to improve antibiotic utilization, diagnostic s …
For many common infectious diseases in both adult and pediatric populations, a significant body of evidence now shows that short-course antimicrobials are just as ...
Antimicrobial Combinations as Novel Indicators for Clostridioides difficile infection development: Population-Based, Nested Case-Controlled Study in Japan-The Shizuoka Kokuho Database Study - PubMed
CDI prevalence increased with the number of antimicrobial classes used in combination. Certain types or combinations of antimicrobials may increase the OR for CDI.
INSPIRE Trials: Reducing Antibiotic Prescribing For Skin and Soft Tissue And Abdominal Infections
Led by Shruti K. Gohil, MD, MPH, the trials examined how computerized physician order entry prompts can reduce the use of extended-spectrum antibiotics in hospitalized patients while maintaining patient safety.
Grant given to Intermountain Health to address antibiotic issues
Intermountain Health researchers have received a grant to address the problem of antibiotic overuse and resistance in urgent care and outpatient clinics. The $356,000 grant from Merck will launch the Intermountain ReSCORE-UC project, which will be a two-year study to better understand how to maintain proper antibiotic prescribing in outpatient settings. The goal is to […]
Clostridioides difficile Infection following Procalcitonin-guided Antibiotic Therapy for COVID-19 - PubMed
We present a case of a 50-year-old man with chronic kidney disease (CKD) presenting with acute diarrhea and fever. He was admitted a month prior for COVID-19, where he received antibiotics for radiographic findings of pneumonia and elevated procalcitonin. In the emergency department, his stool sampl …
Risk of Clostridioides difficile infection in inflammatory bowel disease patients undergoing vedolizumab treatment: a systematic review and meta-analysis - PubMed
The study was registered on the PROSPERO registry (CRD42023465986).
The Impact of Clinical Pharmacist-Driven Weekend Antimicrobial Stewardship Coverage at a Quaternary Hospital - PubMed
The pharmacist-driven weekend AMS is an opportunity for pharmacists to intervene and optimize patients' care plans. This initiative demonstrated significant increased AMS-related interventions, promoted judicious antimicrobial use, and contributed to a reduced length of hospital stay. Our findings n …
Risk of Clostridioides difficile infection in inflammatory bowel disease patients undergoing vedolizumab treatment: a systematic review and meta-analysis - BMC Gastroenterology
Background Inflammatory bowel disease (IBD) is a chronic, relapsing condition wherein biologics have improved disease prognosis but introduced elevated infection susceptibility. Vedolizumab (VDZ) demonstrates unique safety advantages; however, a comprehensive systematic comparison regarding the risk of Clostridioides difficile infection (CDI) between vedolizumab and alternative medications remains absent. Method Medline, Embase, Cochrane, and clinicaltrials.gov registry were comprehensively searched. Pooled estimates of CDI proportion, incidence, pooled risk ratio between ulcerative colitis (UC) and Crohn’s disease (CD), vedolizumab and other medications were calculated. Data synthesis was completed in R using the package “meta”. Results Of the 338 studies initially identified, 30 met the inclusion/exclusion criteria. For CDI risk, the pooled proportion was 0.013 (95% CI 0.010–0.017), as well as the pooled proportion of serious CDI was 0.004 (95% CI 0.002–0.008). The comparative pooled risk ratios revealed: UC versus CD at 2.25 (95% CI 1.73–2.92), vedolizumab versus anti-TNF agents at 0.15 (95% CI 0.04–0.63) for UC and 1.29 (95% CI 0.41–4.04) for CD. Conclusion The overall CDI risk in IBD patients exposed to vedolizumab was estimated to be 0.013. An increased risk of CDI was noted in UC patients receiving vedolizumab compared to those with CD. Vedolizumab potentially offers an advantage over anti-TNF agents for UC regarding CDI risk, but not for CD. Trial registration The study was registered on the PROSPERO registry (CRD42023465986).
Comparative safety of different antibiotic regimens for the treatment of outpatient community-acquired pneumonia among otherwise healthy adults - PubMed
Broad-spectrum antibiotics were associated with increased risk of ADEs among otherwise healthy adults treated for CAP in the outpatient setting. Antimicrobial stewardship is needed to promote judicious use of broad-spectrum antibiotics and ultimately decrease antibiotic-related ADEs.
Gut Microbiota Disruption in Hematologic Cancer Therapy: Molecular Insights and Implications for Treatment Efficacy - PubMed
Hematologic malignancies (HMs), including leukemia, lymphoma, and multiple myeloma, involve the uncontrolled proliferation of abnormal blood cells, posing significant clinical challenges due to their heterogeneity and varied treatment responses. Despite recent advancements in therapies that have imp …
Antibiotic subclasses differentially perturb the gut microbiota in kidney transplant recipients - PubMed
Beta-lactam antibiotics and FQ antibiotics have a profound impact on the gut microbiota in kidney transplant recipients. Given the link of the gut microbiota to infectious complications, antibiotic associated changes in the microbiota may lead to an increased risk for further infections.
Strengthening Defenses: Integrating Infection Control With Antimicrobial Stewardship
Use this handout to explain the basics of why infection prevention and control and antimicrobial stewardship are essential and how the 2 fields must have a unified approach to patient and staff safety
Postoperative outcomes after receipt of ertapenem antimicrobial prophylaxis for colon surgery: a multicenter retrospective cohort study - PubMed
Ertapenem use for perioperative prophylaxis was associated with increased odds of SSI among patients undergoing colon surgery in our study population, though no differences in CDI or clinical CRE culture positivity were identified. Further study and replication of these findings are needed.
Hospitalized Patients on Proton Pump Inhibitors for Stress Ulcer Prophylaxis Have a Higher Risk of Clostridioides difficile Infection Compared to Those on Histamine-2 Receptor Antagonists - PubMed
The risk of occurrence CDI for hospitalized patients using PPIs for SUP was higher than using H2RAs. It is recommended not to exceed 14 days of any gastric ASDs for SUP during hospitalization, especially for patients who have used high-risk antibiotics, been admitted to the ICU, or have immunodefici …
Efficacy and safety of a preventive strategy against tuberculosis in liver transplantation recipients including the treatment of latent infection with moxifloxacin - PubMed
A preventive strategy based on systematic LTBI screening and moxifloxacin treatment before LT in positive cases appears safe and effective in preventing the development of tuberculosis in LT recipients. However, our findings are limited by a small sample size; thus, larger studies are required to va …
Smart Antibiotics Could Fight Infections While Sparing The Gut
In the period spanning 2017-2021, a mere 12 new antibiotics entered the market, with only one capable of targeting all the pathogens deemed critical by the WHO.
Infections following chimeric antigen receptor T cell therapy: 2018-2022 - PubMed
COVID-19 and C. difficile infection were the most common infections following CAR T-cell therapy. Most infections occurred within the first 100 days. Empiric antibiotic use and C. difficile infection were common in patients with CRS/ICANS, in the absence of documented bacterial infection, thus provi …
Significant drop in serum C-reactive protein in patients with solid neoplasia and bacterial infection is associated with a better prognosis and identifies candidates for short-course antibiotic therapy - PubMed
In this study, cancer patients with a good CRP response during antibiotic therapy presented lower mortality and a higher proportion of satisfactory therapeutic responses. CRP can be a useful tool when combined with other clinical information in optimizing the duration of antimicrobial treatment in a …
Efficacy of prophylactic antibiotics in the adjuvant treatment of alcohol-related liver disease (ALD): a Systematic review and meta-analysis: Prophylactic antibiotics in ALD - PubMed
Prophylactic antibiotic therapy was an effective and safe treatment for advanced ALD. To mitigate the risk of MDR bacterial infections, a strategy of selective intestinal decontamination could be advisable. Future investigations should prioritize varied ALD patient populations with extended follow-u …