A Randomized Controlled Trial of an Electronic Clinical Decision Support Tool for Inpatient Antimicrobial Stewardship.

Background: The weighted incidence syndromic combination antibiogram (WISCA) is an antimicrobial stewardship tool that utilizes electronic medical record data to provide real-time clinical decision support regarding empiric antibiotic prescription in the hospital setting. The aim of this study was to determine the impact of WISCA utilization for empiric antibiotic prescription on hospital length of stay (LOS).

Methods: We performed a crossover randomized controlled trial of the WISCA tool at 4 hospitals.

The epidemiology of blastomycosis in Illinois and factors associated with death.

Background: Blastomycosis is a systemic fungal disease that may be asymptomatic or progressive and may lead to death.

Methods: In response to a reported increase in the number of cases of blastomycosis in Illinois, surveillance data reported to the Illinois Department of Public Health from January 1993 to August 2003 were analyzed and the medical records of 4 patients who died were reviewed.

Results: Among the 500 cases reported, the median age of the patients was 43 years (range, 4-87 years), and 34 patients (7%) died.