Epidemiologic analysis and genotypic characterization of a nosocomial outbreak of vancomycin-resistant enterococci.

We are reporting on a nosocomial outbreak of 213 cases of vancomycin-resistant enterococcus infection involving 2,812 enterococcal isolates from patients over a period of 36 months. In 1990, the Enterococcus faecium vancomycin susceptibility rate was found to be 85.7% (36 of 42 cases), and an incidence of 10.

Multi-purpose evaluation of H2-antagonist usage.

At Cabrini Medical Center, drug usage evaluation (DUE) and monthly purchasing data analysis were used to determine the indications for which H2 antagonists were being used, the appropriateness of parenteral therapy, the use of extended dosing intervals, and the cost effectiveness of cimetidine (Tagamet). The study was also used to review a decision of the P & T Committee to maintain cimetidine and remove ranitidine from the hospital formulary.

Evaluating albumin usage in an urban acute care hospital.

At Cabrini Medical Center, a 499-bed acute care hospital in New York City, a concurrent review of 25% albumin usage was performed. A nationwide shortage, and a 40% increase in usage over the same time period the previous year, provided the justification for the study. Twenty-five percent albumin usage was monitored for a 2-month period.