Characterization of continued antibacterial therapy after diagnosis of hospital-onset Clostridium difficile infection: implications for antimicrobial stewardship.

Study Objectives: To determine the proportion of hospitalized adults with hospital-onset Clostridium difficile infection (CDI) who continued to receive concomitant non-CDI antibacterial agents, to characterize the antibacterial therapy that these patients received before and after the diagnosis of CDI, and to compare hospital outcomes between those patients who did and those who did not have their previous antibacterial therapy discontinued after CDI diagnosis.

Design: Retrospective cohort study.

Data Source: Drug use and administrative discharge data from 42 United States academic medical centers.

Trends in aminoglycoside use and gentamicin-resistant gram-negative clinical isolates in US academic medical centers: implications for antimicrobial stewardship.

Objective: To measure trends in aminoglycoside antibiotic use and gentamicin-resistant clinical isolates across a network of hospitals and compare network-level relationships with those of individual hospitals.

Design: Longitudinal observational investigation.

Setting: US academic medical centers.

Economic impact of Clostridium difficile infection in a multihospital cohort of academic health centers.

Study Objective: To assess the economic impact of Clostridium difficile infection (CDI) in a large multihospital cohort.

Design: Retrospective case-control study.

Data Source: Administrative claims data from 45 academic medical centers.

Antifungal use in hospitalized adults in U.S. academic health centers.

Purpose: Use of antifungal agents and predictors of total antifungal use among adult inpatients at U.S. academic health centers was characterized.

Use of International Classification of Diseases, Ninth Revision, Clinical Modification codes and medication use data to identify nosocomial Clostridium difficile infection.

Objective: The International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code for Clostridium difficile infection (CDI) is used for surveillance of CDI. However, the ICD-9-CM code alone cannot separate nosocomial cases from cases acquired outside the institution. The purpose of this study was to determine whether combining the ICD-9-CM code with medication treatment data for CDI in hospitalized patients could enable us to distinguish between patients with nosocomial CDI and patients who were admitted with CDI.

Trends in antibacterial use in hospitalized pediatric patients in United States academic health centers.

Trends in pediatric antibacterial use were examined in 20 academic health centers during the period 2002-2007. There was a significant increase in the use of linezolid (P < .001) and of macrolides (P = .

Relationship of carbapenem restriction in 22 university teaching hospitals to carbapenem use and carbapenem-resistant Pseudomonas aeruginosa.

Many hospital antimicrobial stewardship programs restrict the availability of selected drugs by requiring prior approval. Carbapenems may be among the restricted drugs, but it is unclear if hospitals that restrict availability actually use fewer carbapenems than hospitals that do not restrict use. Nor is it clear if restriction is related to resistance.

Trends in antibacterial use in US academic health centers: 2002 to 2006.

Background: Antibacterial drug use is a major risk factor for bacterial resistance, but little is known about antibacterial use in US hospitals. The objectives of this study were to characterize trends in antibacterial use in a sample of US hospitals and to identify predictors of use.

Methods: We measured systemic antibacterial use from validated claims data at 22 university teaching hospitals from January 1, 2002, through December 31, 2006, and we examined potential predictors of use in 2006, including hospital and patient demographics and antibacterial stewardship policies.

Use and outcomes of antifibrinolytic therapy in patients undergoing cardiothoracic surgery at 20 academic medical centers in the United States.

Background: Several clinical trials have shown an association between the use of aprotinin in cardiothoracic surgery (CTS) patients and an increased risk of adverse renal, cardiovascular, and cerebrovascular events. Other antifibrinolytic agents-aminocaproic acid (AA) and tranexamic acid (TA)-have not shown elevated risks. Using a large administrative data set, we sought to examine these findings.

Outcomes associated with vasoactive therapy in patients with acute decompensated heart failure.

Study Objectives: To describe the clinical management of acute decompensated heart failure (ADHF) in patients receiving intravenous treatment with dobutamine, milrinone, or nesiritide, and to evaluate differences, based on treatment received, in the in-hospital mortality rate, length of stay (LOS), total health care costs, and 30-day hospital readmission rate.

Design: Retrospective cohort analysis.

Data Source: University HealthSystem Consortium (UHC) Clinical Database Pharmacy, a database with information from 32 academic hospitals.

The power of collaboration: using internet-based tools to facilitate networking and benchmarking within a consortium of academic health centers.

The University HealthSystem Consortium (UHC) represents a strategic alliance of 169 academic health centers and associated institutions engaged in knowledge sharing and idea-generation. The use of the Internet as a tool in the delivery of UHC's products and services has increased dramatically over the past year and will continue to increase during the foreseeable future. This paper examines the current state of UHC-member institution driven tools and services that utilize the Web as a fundamental component in their delivery.