Blood Culture Use in Medical and Surgical Intensive Care Units and Wards.

Importance: Blood culture (BC) use benchmarks in US hospitals have not been defined.

Objective: To characterize BC use in adult intensive care units (ICUs) and wards in US hospitals.

Design, Setting, And Participants: A retrospective cross-sectional study of BC use in adult medical ICUs, medical-surgical ICUs, medical wards, and medical-surgical wards from acute care hospitals from the 4 US geographic regions was conducted.

The role of empiric atypical antibiotic coverage in non-severe community-acquired pneumonia.

A β-lactam plus a macrolide or a respiratory fluoroquinolone alone is recommended as standard empiric antibacterial therapy for non-severe adults hospitalized with community-acquired pneumonia (CAP) per Infectious Diseases Society of America guidelines. However, the evidence in support of adding empiric atypical antibacterial therapy, and specifically the addition of a macrolide, is conflicting and should be balanced with additional factors: the necessity of covering atypical organisms, benefits of macrolide-associated immunomodulation, harms associated with antibiotic use, and selection for antibiotic-resistant organisms. In this review, we examine the role of atypical coverage in standard treatment regimens for patients admitted with non-severe CAP and specifically focus on the addition of macrolides to β-lactams.

Antimicrobial stewardship to reduce overtreatment of asymptomatic bacteriuria in critical access hospitals: measuring a quality improvement intervention.

Background: Asymptomatic bacteriuria (ASB) treatment is a common form of antibiotic overuse and diagnostic error. Antibiotic stewardship using the inappropriate diagnosis of urinary tract infection (ID-UTI) measure has reduced ASB treatment in diverse hospitals. However, critical access hospitals (CAHs) have differing resources that could impede stewardship.