Impact of A Collaborative Strategy to Reduce the Inappropriate Use of Acid Suppressive Therapy in Non-Intensive Care Unit Patients.

Background: Stress ulcer prophylaxis (SUP) is inappropriately prescribed in more than 30% of non-intensive care unit (ICU) patients, leading to unnecessary adverse events as well as increases in economic burden.

Objective: There was an increasing trend in the prophylactic use of acid suppressive therapy (AST) in non-critically ill patients at our institution, which prompted this initiative aimed at reducing the inappropriate use of AST in non-ICU patients.

Methods: This was a retrospective interventional study that consisted of formulation of a guideline, education to the hospitalist service, and intervention by clinical pharmacists.

An Evaluation of Selected Indications and Appropriateness of Ampicillin/Sulbactam, an Unrestricted Antimicrobial, at a Single Center.

Background: With antimicrobial resistance on the rise and few new agents in development, it is important to exercise prudent judgment when utilizing antimicrobials. The Antimicrobial Stewardship Program (ASP) is responsible for facilitating the appropriate use of antimicrobials at the institution. Restricted antimicrobials and select additional antimicrobials are monitored by the ASP team to determine if the indications chosen by the ordering prescribers correspond to and are appropriate for the patients' infections.

Past, present, and future therapies for Clostridium difficile-associated disease.

Objective: To describe and examine the past, present, and potential future treatment options for Clostridium difficile-associated disease (CDAD).

Data Sources: A PubMed search, restricted to English-language articles concerning CDAD, was conducted (1965-October 2006) using the key words Clostridium difficile, diarrhea, vancomycin, metronidazole, immunoglobulin, and recurrence. Additional references were located through review of the bibliographies of cited articles and by visiting www.

Extending the nurse practitioner concurrent intervention model to community-acquired pneumonia and chronic obstructive pulmonary disease.

Background: A Nurse Practitioner (NP) Concurrent Intervention Model shown effective for controlling telemetry usage was extended to patients with community-acquired pneumonia (CAP) and patients with chronic obstructive pulmonary disease (COPD).

Methods: In spring 2000, investigators at Hackensack University Medical Center and the University of Medicine and Dentistry of New Jersey-New Jersey Medical School began an intervention to increase compliance with the Centers for Medicare & Medicaid Services (CMS) performance measures for CAP. Cost-reduction efforts were introduced by using previously described criteria for switching from intravenous to oral medication and for hospital discharge.

Relationship between fluoroquinolone use and changes in susceptibility to fluoroquinolones of selected pathogens in 10 United States teaching hospitals, 1991-2000.

We retrospectively examined the relationship between fluoroquinolone use and the susceptibilities of 11 bacterial pathogens to fluoroquinolones in 10 US teaching hospitals from 1991 through 2000. Statistical significance was determined by 2-way analysis of variance, with the number of isolates tested each year as a weighting factor. The analysis of baseline-to-end point change in the percentage of susceptibility and the slope of the regression line (trend line) for logit percentage of susceptibility showed that the overall percentage of susceptibility to fluoroquinolones decreased significantly during the study period (P<.