Antibiotic Prescribing Practices for Upper Respiratory Tract Infections Among Primary Care Providers: A Descriptive Study.

Background: Most antibiotics are prescribed in the ambulatory setting with estimates that up to 50% of use is inappropriate. Understanding factors associated with antibiotic misuse is essential to advancing better stewardship in this setting. We sought to assess the frequency of unnecessary antibiotic use for upper respiratory infections (URIs) among primary care providers and identify patient and provider characteristics associated with misuse.

Clinical and Financial Impact of Rapid Antimicrobial Susceptibility Testing in Blood Cultures.

The rapid identification of pathogens that cause bloodstream infections plays a vital role in the modern clinical microbiology laboratory. Despite demonstrating a significant reduction in turnaround time and a significant effect on clinical decisions, most methods do not provide complete antimicrobial susceptibility testing (AST) information. We employed rapid identification (ID) and AST using the Accelerate PhenoTest on positive blood cultures containing Gram-negative bacilli.

Outcomes Associated With Standardized Ideal Body Weight Dosing of Intravenous Immune Globulin in Hospitalized Patients: A Multicenter Study.

There are limited outcomes data for ideal body weight (IBW)-based dosing of intravenous immune globulin (human, IVIG) in hospitalized patients. To investigate clinical outcomes associated with a standardized change from total body weight to IBW-based dosing of IVIG. This was a retrospective, multicenter, pre-post sequential period analysis.

Impact of a Comprehensive COPD Therapeutic Interchange Program on 30-Day Readmission Rates in Hospitalized Patients.

Purpose: Chronic obstructive pulmonary disease (COPD) is the third leading cause of death in the United States. The economic effect of COPD management is substantial, and the prevalence of the disease continues to rise with the growth of older populations. The purpose of this study was to evaluate the clinical and financial impact of a comprehensive therapeutic interchange program (CTIP) in hospitalized patients with COPD.

Ticagrelor and Acetylsalicylic Acid after Placement of Pipeline Embolization Device for Cerebral Aneurysm: A Case Series.

Background: Dual antiplatelet therapy with acetylsalicylic acid (ASA) and a P2Y12-receptor antagonist is often used to prevent thrombotic complications after placement of a Pipeline embolization device (PED) for cerebral aneurysm. Although clopidogrel is common in this setting, high rates of nonresponse to this drug have made ticagrelor a potentially attractive alternative.

Objective: To describe safety and efficacy outcomes for ticagrelor following PED placement, including measurement of platelet function.

Failure of a Best Practice Alert to Reduce Antibiotic Prescribing Rates for Acute Sinusitis Across an Integrated Health System in the Midwest.

Background: Antimicrobial resistance is a growing concern, and in recent years, there has been increased interest in ambulatory antimicrobial stewardship. Acute rhinosinusitis (ARS) is one of the most common outpatient diagnoses that results in an antibiotic prescription.

Objective: To determine if a best practice alert (BPA) will affect the percentage of oral antibiotic prescriptions for adults with ARS.

A Case Series of 18 Patients Receiving Ticagrelor After Carotid Stenting.

Purpose: Dual antiplatelet therapy (DAPT) with aspirin and a P2Y12 receptor antagonist is often used to prevent thrombotic complications after endovascular stent placement. Most of the published experience surrounding DAPT after carotid stenting is with clopidogrel. Ticagrelor may be a promising alternative, especially in patients who may be considered nonresponders to clopidogrel.

A Pilot Study for Antimicrobial Stewardship Post-Discharge: Avoiding Pitfalls at the Transitions of Care.

Purpose: Lack of patient follow-up is a major concern during care transitions, and the role of an antimicrobial stewardship program (ASP) in assessing antimicrobial regimens after hospital discharge is not well described. We implemented an expanded ASP to include patients recently discharged from the hospital and measured its impact on inappropriate antimicrobial therapy 72 hours after inpatient culture data were finalized.

Methods: A prospective cohort study was conducted at a 583-bed tertiary care center in the Upper Midwest of America.