Validation of a model to predict the risk of nephrotoxicity in patients receiving colistin.

Despite concerns about its nephrotoxicity, colistin often remains the only effective agent for treating multidrug-resistant Gram-negative infections. Published studies have reported a wide range of nephrotoxicity risk factors. To assess the clinical utility of various models, we compared their performances for predicting the risk of nephrotoxicity.

Healthcare resource utilization for recurrent Clostridium difficile infection in a large university hospital in Houston, Texas.

Background: There are limited data examining healthcare resource utilization in patients with recurrent Clostridium difficile infection (CDI).

Methods: Patients with CDI at a tertiary-care hospital in Houston, TX, were prospectively enrolled into an observational cohort study. Recurrence was assessed via follow-up phone calls.

Clinical practice patterns in hospitalized patients at risk for invasive candidiasis: role of antifungal stewardship programs in an era of rapid diagnostics.

Background: Rapid diagnostic tests for Candida are becoming available that may supplement traditional microbiological identification.

Objective: Assess clinical practice patterns in patients with or at risk of candidiasis who may benefit from the use of rapid diagnostic tests.

Methods: This was a prospective cohort study of patients with candidemia or receiving systemic antifungals conducted at a university-affiliated tertiary care hospital.

Evaluation of a daptomycin dose-optimization protocol.

Purpose: The impact of an institutional protocol intended to improve daptomycin dosing for vancomycin-resistant enterococci (VRE) infections was investigated.

Summary: Daptomycin has been reported to have optimal activity against VRE at weight-based doses of ≥8 mg/kg. As part of an initiative to optimize daptomycin dosing for all indications and regimens, a large medical center implemented a protocol restricting daptomycin prescribing to infectious-diseases specialists and a nomogram recommending elevated daptomycin dosing for all VRE infections, with baseline and weekly creatinine phosphokinase (CPK) determinations during daptomycin therapy.

Impact of prior inappropriate fluconazole dosing on isolation of fluconazole-nonsusceptible Candida species in hospitalized patients with candidemia.

Prior use of fluconazole is a modifiable risk factor for the isolation of fluconazole-nonsusceptible Candida species. Optimization of the use of fluconazole by appropriate dose or duration may be able to minimize the risk of resistance. The objective of this study was to evaluate the effects of prior fluconazole therapy, including the dose and duration, on fluconazole susceptibility among Candida species isolated from hospitalized patients with candidemia.

A real-world evaluation of oral vancomycin for severe Clostridium difficile infection: implications for antibiotic stewardship programs.

Study Objective: To assess antibiotic treatment patterns and clinical outcomes of patients with Clostridium difficile infection (CDI) based on underlying severity of CDI disease.

Design: Retrospective analysis of data from a prospective cohort study.

Setting: Large tertiary care university hospital.

Improving patient care through implementation of an antimicrobial stewardship program.

Purpose: The implementation of an antimicrobial stewardship program at a health system is described.

Summary: In 2008, the Center for Antimicrobial Stewardship and Epidemiology (CASE) was formed at St. Luke's Episcopal Hospital (SLEH) to improve the quality of care for patients as it related to antimicrobial therapy.

Significant publications on infectious diseases pharmacotherapy in 2009.

Purpose: Significant publications on infectious diseases (ID) pharmacotherapy in 2009 are summarized.

Summary: On December 31, 2009, the Houston Infectious Diseases Network amassed a list of articles identified as having a significant impact on ID pharmacotherapy. Articles selected were published between January 1, 2009, and December 31, 2009, in prominent, peer-reviewed journals.

49th ICAAC annual meeting: optimization of anti-infective use in the clinical setting.

The meeting of the American Society of Microbiology was recently held in San Francisco, CA, USA - a gathering of experts in the fields of infectious diseases, microbiology and the pharmaceutical industry, among others. Owing to this large attendance and extensive coverage of many infectious disease topics, we focus on the optimization of anti-infective use in the clinical setting. We will cover antimicrobial stewardship, drugs with Gram-positive activity, and antifungal and antiretroviral agents.