Antimicrobial agents for surgical infections.

Antimicrobial drugs are useful for the empiric and definitive treatment of infections in surgical patients. They are also important agents for perioperative antimicrobial prophylaxis. The proper selection and use of these drugs is a critical skill for surgeons.

Validation of Surgical Intensive Care-Infection Registry: a medical informatics system for intensive care unit research, quality of care improvement, and daily patient care.

Background: We developed a prototype electronic clinical information system called the Surgical Intensive Care-Infection Registry (SIC-IR) to prospectively study infectious complications and monitor quality of care improvement programs in the surgical and trauma intensive care unit. The objective of this study was to validate SIC-IR as a successful health information technology with an accurate clinical data repository.

Study Design: Using the DeLone and McLean Model of Information Systems Success as a framework, we evaluated SIC-IR in a 3-month prospective crossover study of physician use in one of our two surgical and trauma intensive care units (SIC-IR unit versus non SIC-IR unit).

A prospective study of the impact of a critical care pharmacist assigned as a member of the multidisciplinary burn care team.

A critical care clinical pharmacy specialist was assigned to the burn center to make scheduled rounds with the physicians and to attend the weekly multidisciplinary burn team rounds. A prospective 6-month study was completed to 1) determine the clinical impact of the pharmacist's interventions and 2) quantify cost savings generated by these interventions. Prospective data concerning clinical interventions by the pharmacist were collected during a 6-month period.

Unnecessary use of antimicrobials in hospitalized patients: current patterns of misuse with an emphasis on the antianaerobic spectrum of activity.

Background: Unnecessary use of antimicrobials contributes to the emergence and dissemination of antimicrobial-resistant nosocomial pathogens in part through elimination of normal anaerobic bacterial flora that inhibit overgrowth of pathogenic microorganisms.

Methods: A prospective observational study was conducted in a 650-bed, university-affiliated hospital. All adult nonintensive care inpatients for whom new antimicrobials were prescribed during a 2-week period were monitored throughout their hospitalization.