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Not Just an Oxymoron: The Utilitarian's Guide to Antimicrobial Stewardship in Transplant Infectious Diseases.
Transpl Infect Dis
December 2024
Division of Infectious Disease and Tropical Medicine, MedStar Georgetown University Hospital, Washington, District of Columbia, USA.
Solid organ transplant and hematopoietic cell transplant patients face an increased risk of infectious diseases, greater exposure to antibiotics, and heightened risk of multidrug-resistant organisms (MDROs) due to their immunosuppressed state. Antimicrobial stewardship programs (ASP) are essential in reducing the incidence of MDRO by conserving antimicrobial use, minimizing treatment durations, and improving the appropriate use of diagnostic testing. However, the role of ASP in transplant infectious diseases (TID) is still evolving, necessitating greater collaboration between ASP and transplant programs.
View Article and Find Full Text PDFPreadmission Penicillin Allergy Evaluation Before Hematopoietic Stem Cell Transplantation Optimizes Febrile Neutropenia Treatment and Inpatient Resource Utilization.
Transplant Cell Ther
November 2024
Division of Allergy & Clinical Immunology, Brigham and Women's Hospital, Boston, Massachusetts.
Febrile neutropenia is a common complication of conditioning chemotherapy for hematopoietic stem cell transplant (HSCT), but a major barrier for optimal treatment of febrile neutropenia is historical penicillin allergies. Our group recently published a development of a clinical pipeline for delabeling penicillin allergies in adult patients planned to undergo hematopoietic stem cell transplant (HSCT). In this retrospective cohort study, we followed patients to evaluate their outcomes during inpatient admission for HSCT.
View Article and Find Full Text PDFPediatric Residents Knowledge of Penicillin Allergy.
Clin Pediatr (Phila)
May 2024
Division of Infectious Diseases, State University of New York Downstate Health Sciences University, Brooklyn, NY, USA.
Penicillin allergy knowledge has not been evaluated specifically in the pediatric resident population. An anonymous electronic survey was distributed to all the pediatric residents in a single residency program to ascertain knowledge of penicillin allergies and allergy history taking skills. Responses among each resident class were compared using the Fisher exact test, 2-tailed.
View Article and Find Full Text PDFBring it on again: antimicrobial stewardship in transplant infectious diseases: updates and new challenges.
Antimicrob Steward Healthc Epidemiol
January 2024
Sinai Health-University Health Network Antimicrobial Stewardship Program, University Health Network, Toronto, ON, Canada.
Advancement in solid organ transplantation and hematopoietic stem cell transplant continues to improve the health outcomes of patients and widens the number of eligible patients who can benefit from the medical progress. Preserving the effectiveness of antimicrobials remains crucial, as otherwise transplant surgeries would be unsafe due to surgical site infections, and the risk of sepsis with neutropenia would preclude stem cell transplant. In this review, we provide updates on three previously discussed stewardship challenges: febrile neutropenia, infection, and asymptomatic bacteriuria.
View Article and Find Full Text PDFCommunity-acquired bacterial pneumonia in children: an update on antibiotic duration and immunization strategies.
Curr Opin Pediatr
April 2024
Department of Pediatrics, Division of Infectious Diseases, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas, USA.
Purpose Of Review: This review is structured to update clinicians on the epidemiology, antibiotic treatment, and prevention of pediatric bacterial pneumonia. The review provides information regarding the current research on antibiotic management for bacterial pneumonia and the newest immunization recommendations to prevent pneumococcal pneumonia and other respiratory infections.
Recent Findings: The recommended length of antibiotic therapy for bacterial pneumonia has been discrepant between low-income and high-income countries.
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