Reducing inappropriate antibiotic prescribing for acute uncomplicated bronchitis: a systemwide quality improvement project.

This systemwide quality improvement project examined whether a bundle of antimicrobial stewardship interventions reduced the proportion of inappropriate antibiotic prescriptions in ambulatory encounters for adults with acute uncomplicated bronchitis. There was an overall reduction in the proportion of inappropriate prescriptions from pre- to postinterventions (44.9%-32.

Long-Acting Antiretroviral Drug Therapy in Adolescents: Current Status and Future Prospects.

Approximately 50% of human immunodeficiency virus (HIV)-infected adolescents fail to achieve complete viral suppression, largely due to nonadherence to their antiretroviral drug regimens. Numerous personal, financial, and societal barriers contribute to nonadherence, which may lead to the development of HIV drug resistance. Long-acting antiretroviral drugs hold the promise of improved adherence because they remove the need for swallowing one or more pills daily.

Risk Factors for Acquisition of Extended-spectrum Beta-lactamase and AmpC Resistant Gram-negative Bacteria in Critically Ill Infants With Congenital Heart Disease.

In a cohort of 257 infants with congenital heart disease admitted to the pediatric intensive care unit, 22 infants had positive cultures for extended-spectrum beta-lactamase or AmpC Gram-negative bacteria. These infants had longer exposure to broad-spectrum antibiotics, greater support with invasive devices and longer intensive care and hospital lengths of stay.

A prospective multi-center quality improvement initiative (NINJA) indicates a reduction in nephrotoxic acute kidney injury in hospitalized children.

Nephrotoxic medication (NTMx) exposure is a common cause of acute kidney injury (AKI) in hospitalized children. The Nephrotoxic Injury Negated by Just-in time Action (NINJA) program decreased NTMx associated AKI (NTMx-AKI) by 62% at one center. To further test the program, we incorporated NINJA across nine centers with the goal of reducing NTMx exposure and, consequently, AKI rates across these centers.