National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Alcohol Use (1)
- Antibiotics (6)
- Antimicrobial Stewardship (3)
- Children/Adolescents (7)
- Clinical Decision Support (CDS) (1)
- Clostridium difficile Infections (1)
- (-) Community-Acquired Infections (27)
- Comparative Effectiveness (2)
- Diagnostic Safety and Quality (1)
- Elderly (3)
- Emergency Department (1)
- Guidelines (1)
- Healthcare-Associated Infections (HAIs) (3)
- Healthcare Cost and Utilization Project (HCUP) (1)
- Healthcare Costs (1)
- Health Information Technology (HIT) (1)
- Hospitalization (4)
- Imaging (1)
- Infectious Diseases (8)
- Influenza (2)
- Inpatient Care (1)
- Medication (7)
- Methicillin-Resistant Staphylococcus aureus (MRSA) (1)
- Mortality (2)
- Outcomes (4)
- Patient-Centered Outcomes Research (3)
- (-) Pneumonia (27)
- Quality Improvement (1)
- Quality of Care (1)
- Respiratory Conditions (9)
- Risk (3)
- Shared Decision Making (1)
- Substance Abuse (1)
- Urinary Tract Infection (UTI) (1)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 27 Research Studies DisplayedGeanacopoulos AT, Neuman MI, Michelson KA
Cost of pediatric pneumonia episodes with or without chest radiography.
Researchers sought to assess the costs of community-acquired pneumonia (CAP) episodes with and without chest radiograph (CXR) among children discharged from the pediatric emergency department. Their retrospective cohort study used data from the Healthcare Cost and Utilization Project State ED and Inpatient Databases on children aged 3 months to 18 years with CAP in eight states from 2014 to 2019. The results indicated that use of CXR for CAP diagnosis is associated with lower costs when considering the subsequent provision of care among patients who need additional health care after initial emergency department discharge.
AHRQ-funded; HS026503; HS000063.
Citation: Geanacopoulos AT, Neuman MI, Michelson KA .
Cost of pediatric pneumonia episodes with or without chest radiography.
Hosp Pediatr 2024 Feb; 14(2):146-52. doi: 10.1542/hpeds.2023-007506.
Keywords: Healthcare Cost and Utilization Project (HCUP), Children/Adolescents, Pneumonia, Respiratory Conditions, Community-Acquired Infections
Deshpande A, Walker R, Schulte R
Reducing antimicrobial overuse through targeted therapy for patients with community-acquired pneumonia: a study protocol for a cluster-randomized factorial controlled trial (CARE-CAP).
The authors described a planned cluster-randomized controlled trial in 12 hospitals in the Cleveland Clinic Health System to test two approaches to reducing the use of extended-spectrum antibiotics (ESA) in adult patients with community-acquired pneumonia (CAP): rapid diagnostic assays that provide accurate results within hours, and de-escalation after negative bacterial cultures in clinically stable patients. The purpose will be to establish whether the identification of an etiological agent early and pharmacist-led de-escalation can safely reduce the use of ESA in patients with CAP. The findings may also inform clinical guidelines on the management of CAP.
AHRQ-funded; HS028633.
Citation: Deshpande A, Walker R, Schulte R .
Reducing antimicrobial overuse through targeted therapy for patients with community-acquired pneumonia: a study protocol for a cluster-randomized factorial controlled trial (CARE-CAP).
Trials 2023 Sep 16; 24(1):595. doi: 10.1186/s13063-023-07615-3..
Keywords: Antibiotics, Antimicrobial Stewardship, Medication, Community-Acquired Infections, Pneumonia, Respiratory Conditions
Deshpande A, Klompas M, Guo N
Intravenous to oral antibiotic switch therapy among patients hospitalized with community-acquired pneumonia.
The purpose of this retrospective cohort study was to examine clinical practice guidelines which recommend switching from intravenous (IV) to oral antibiotics once patients are clinically stable. The researchers conducted a study of adults admitted with CAP from 2010 through 2015 and initially treated with IV antibiotics at 642 US hospitals. Switching was defined as discontinuation of IV and initiation of oral antibiotics without interrupting therapy. Patients switched by hospital day 3 were considered early switchers. The study found that of 78,041 CAP patients, 6% were switched early, most frequently to fluoroquinolones. Patients switched early had fewer days on IV antibiotics, shorter duration of inpatient antibiotic treatment, shorter LOS, and lower hospitalization costs, but no significant excesses in 14-day in-hospital mortality or late ICU admission. Patients at a greater mortality risk were less likely to be switched. However, even in hospitals with relatively high switch rates, less than 15% of very low-risk patients were switched early.
AHRQ-funded; HS029477; HS025026.
Citation: Deshpande A, Klompas M, Guo N .
Intravenous to oral antibiotic switch therapy among patients hospitalized with community-acquired pneumonia.
Clin Infect Dis 2023 Jul 26; 77(2):174-85. doi: 10.1093/cid/ciad196..
Keywords: Antibiotics, Community-Acquired Infections, Pneumonia, Respiratory Conditions, Medication
Geanacopoulos AT, Neuman MI, Lipsett SC
Association of chest radiography with outcomes in pediatric pneumonia: a population-based study.
This study’s objective was to evaluate the association of performing a chest radiograph (CXR) with 7-day hospitalization after emergency department (ED) discharge among pediatric patients with community-acquired pneumonia (CAP). This retrospective cohort study included 206,694 children aged 3 months to 17 years discharged from any ED within 8 states from 2014 to 2019. Secondary outcomes included 7-day ED revisits and a 7-day hospitalization with severe CAP. Among these children diagnosed with CAP, rates of 7-day ED revisit, hospitalization, and severe CAP were 8.9%, 1.6%, and 0.4%, respectively. After adjusting for illness severity, CXR was associated with fewer 7-day hospitalizations (1.6% vs 1.7%). CXR performance varied somewhat between EDs (median 91.5%). EDs in the highest quartile had fewer 7-day hospitalizations (1.4% vs 1.9%), ED revisits (8.5% vs 9.4%), and hospitalizations for severe CAP (0.3% vs 0.5%) as compared to EDs with the lowest quartile of CXR utilization.
AHRQ-funded; HS026503.
Citation: Geanacopoulos AT, Neuman MI, Lipsett SC .
Association of chest radiography with outcomes in pediatric pneumonia: a population-based study.
Hosp Pediatr 2023 Jul; 13(7):614-23. doi: 10.1542/hpeds.2023-007142..
Keywords: Children/Adolescents, Imaging, Pneumonia, Respiratory Conditions, Community-Acquired Infections
Rothberg MB, Haessler S, Deshpande A
Derivation and validation of a risk assessment model for drug-resistant pathogens in hospitalized patients with community-acquired pneumonia.
The purpose of this study was to develop and validate a model for risk of resistance to first-line community-acquired pneumonia (CAP) therapy. The study was conducted using data for adults hospitalized for CAP from 177 Premier Healthcare database hospitals and 11 Cleveland Clinic hospitals. The study found that among 138,762 eligible patients in the Premier database, 8.8% had positive cultures and 3.8% had organisms resistant to CAP therapy. The strongest predictor of resistance was infection with a resistant organism in the previous year. Markers of acute illness such as receipt of mechanical ventilation or vasopressors, and chronic illness such as pressure ulcer or paralysis were also related with resistant infections. The study model outperformed the Drug Resistance in Pneumonia (DRIP) model in the Premier holdout sample, the Cleveland Clinic hospitals sample. Clinicians at Premier facilities utilized broad-spectrum antibiotics for 20%-30% of their patients. In discriminating between patients with and without resistant infections, physician judgment slightly outperformed the DRIP instrument but not the study model.
AHRQ-funded; HS024277.
Citation: Rothberg MB, Haessler S, Deshpande A .
Derivation and validation of a risk assessment model for drug-resistant pathogens in hospitalized patients with community-acquired pneumonia.
Infect Control Hosp Epidemiol 2023 Jul; 44(7):1143-50. doi: 10.1017/ice.2022.229..
Keywords: Community-Acquired Infections, Pneumonia, Risk
Patel P, Deshpande A, Yu PC
Association of fluoroquinolones or cephalosporin plus macrolide with Clostridioides difficile infection (CDI) after treatment for community-acquired pneumonia.
The purpose of this study was to explore the relationships between the antibiotic regimens of empiric therapy with a respiratory fluoroquinolone or cephalosporin plus macrolide combination and the development of hospital-onset Clostridioides difficile infection (CDI). The researchers used data from 638 United States hospitals and included adults admitted with pneumonia and discharged from July 2010 through June 2015 with a pneumonia diagnosis code who received 3 or more days of either antibiotic regimen. The study sample included 58,060 patients treated with either cephalosporin plus macrolide (36,796 patients) or a fluoroquinolone alone (21,264 patients). 0.35% of patients who received cephalosporin plus macrolide and 0.31% who received a fluoroquinolone developed CDI, making CDI risks similar for fluoroquinolones versus cephalosporin plus macrolide.
AHRQ-funded; HS024277.
Citation: Patel P, Deshpande A, Yu PC .
Association of fluoroquinolones or cephalosporin plus macrolide with Clostridioides difficile infection (CDI) after treatment for community-acquired pneumonia.
Infect Control Hosp Epidemiol 2023 Jan; 44(1):47-54. doi: 10.1017/ice.2022.60..
Keywords: Pneumonia, Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Medication, Infectious Diseases, Community-Acquired Infections
Deshpande A, Klompas M, Yu PC A, Klompas M, Yu PC
Influenza testing and treatment among patients hospitalized with community-acquired pneumonia.
This study looked at testing rates for influenza in hospitalized patients admitted for community-acquired pneumonia (CAP) and whether it is associated with antiviral treatment and shorter antibiotic courses. The study included patients admitted in 179 US hospitals with pneumonia from 2010 to 2015. The authors assessed influenza testing and compared antimicrobial utilization and the outcomes of test-positive, test-negative, and untested patients. Among 166,268 patients with CAP, 23.3% were tested for influenza, of whom 11.5% tested positive. Testing increased from 15.4% to 35.5% from 2010 to 2015 and was more than triple the rate during flu season (October-May) vs June to September. Patients who tested positive for influenza received antiviral agents more often and antibiotics less often and for shorter courses than patients testing negative. Patients who received early antiviral treatment with oseltamivir experienced lower 14-day in-hospital mortality, lower costs, and shorter length of stay vs patients receiving oseltamivir later or not at all.
AHRQ-funded; HS024277.
Citation: Deshpande A, Klompas M, Yu PC A, Klompas M, Yu PC .
Influenza testing and treatment among patients hospitalized with community-acquired pneumonia.
Chest 2022 Sep;162(3):543-55. doi: 10.1016/j.chest.2022.01.053..
Keywords: Influenza, Pneumonia, Community-Acquired Infections, Outcomes, Medication, Inpatient Care
Vaughn VM, Gandhi TN, Hofer TP
A statewide collaborative quality initiative to improve antibiotic duration and outcomes in patients hospitalized with uncomplicated community-acquired pneumonia.
Researchers sought to improve antibiotic duration for community-acquired pneumonia (CAP) across 41 hospitals participating in the Michigan Hospital Medicine Safety Consortium (HMS). They found that, across diverse hospitals, HMS participation was associated with more appropriate use of short-course therapy and fewer adverse events in hospitalized patients with uncomplicated CAP.
AHRQ-funded; HS026530.
Citation: Vaughn VM, Gandhi TN, Hofer TP .
A statewide collaborative quality initiative to improve antibiotic duration and outcomes in patients hospitalized with uncomplicated community-acquired pneumonia.
Clin Infect Dis 2022 Aug 31;75(3):460-67. doi: 10.1093/cid/ciab950..
Keywords: Community-Acquired Infections, Pneumonia, Antibiotics, Antimicrobial Stewardship, Medication, Respiratory Conditions
Rothberg MB, Imrey PB, Guo N MB, Imrey PB, Guo N
A risk model to identify Legionella among patients admitted with community-acquired pneumonia: a retrospective cohort study.
This study’s goal was to derive and externally validate a model to predict a positive Legionella test among adult inpatients diagnosed with pneumonia. The study used data from 177 US hospitals in the Premier Healthcare Database and 12 Cleveland Clinic Health System (CCHS) hospitals. Of 166,689 patients hospitalized for pneumonia, out of 43,070 tested for Legionella 642 (1.5%) tested positive. The strongest predictors of a positive test were a local outbreak, June-October occurrence, hyponatremia, smoking and diarrhea. A negative test was associated with prior admission within 6 months and chronic pulmonary disease.
AHRQ-funded; HS024277.
Citation: Rothberg MB, Imrey PB, Guo N MB, Imrey PB, Guo N .
A risk model to identify Legionella among patients admitted with community-acquired pneumonia: a retrospective cohort study.
J Hosp Med 2022 Aug;17(8):624-32. doi: 10.1002/jhm.12919..
Keywords: Pneumonia, Community-Acquired Infections, Infectious Diseases, Respiratory Conditions
Haessler S, Guo N, Deshpande A
Etiology, treatments, and outcomes of patients with severe community-acquired pneumonia in a large U.S. sample.
This study compared the clinical practice and outcomes in severe community-acquired pneumonia (sCAP) patients to those in non-sCAP patients using guideline-defined criteria for sCAP. The definition for sCAP includes a principal diagnosis of pneumonia or a secondary pneumonia diagnosis paired with a principal diagnosis of sepsis or respiratory failure. One-hundred seventy-seven US hospitals within the Premier Healthcare Database were used to identify 154,799 patients with pneumonia, with 14.1% meeting criteria for sCAP. The sCAP patients had higher organ failure scores and inpatient mortality, longer lengths of stay, and higher costs than those with nonsevere disease. Patients with sCAP had twice the rate of positive blood cultures and respiratory cultures and more often had isolates resistant to first-line community-acquired pneumonia antibiotics. The most common pathogen acquired from blood cultures was Streptococcus pneumoniae and from the respiratory tract Staphylococcus aureus and Pseudomonas species. The most common antibiotics prescribed were vancomycin (65%) and piperacillin-tazobactam (42.8%), regardless of cultures positive for a resistant organism.
AHRQ-funded; HS024277.
Citation: Haessler S, Guo N, Deshpande A .
Etiology, treatments, and outcomes of patients with severe community-acquired pneumonia in a large U.S. sample.
Crit Care Med 2022 Jul;50(7):1063-71. doi: 10.1097/ccm.0000000000005498..
Keywords: Community-Acquired Infections, Pneumonia, Respiratory Conditions, Outcomes
Gupta A, Petty L, Gandhi T
Overdiagnosis of urinary tract infection linked to overdiagnosis of pneumonia: a multihospital cohort study.
This study’s goal was to determine if there is a correlation between overdiagnosis of urinary tract infection (UTI) and overdiagnosis of community-acquired pneumonia (CAP) in hospitals, resulting in unnecessary antibiotic use and diagnostic delays. The authors first determined the proportion of hospitalized patients treated for CAP or UTI at 46 hospitals in Michigan who were overdiagnosed according to national guideline definitions. Then they used Pearson's correlation coefficient to compare hospital proportions of overdiagnosis of CAP and UTI. They included 14,085 patients treated for CAP and 10,398 patients treated for UTI. There was a moderate correlation within hospitals of the proportion of patients overdiagnosed with UTI and those overdiagnosed with CAP.
AHRQ-funded; HS026530.
Citation: Gupta A, Petty L, Gandhi T .
Overdiagnosis of urinary tract infection linked to overdiagnosis of pneumonia: a multihospital cohort study.
BMJ Qual Saf 2022 May;31(5):383-86. doi: 10.1136/bmjqs-2021-013565..
Keywords: Urinary Tract Infection (UTI), Pneumonia, Community-Acquired Infections, Diagnostic Safety and Quality
Bartley PS, Deshpande A, Yu PC
Bacterial coinfection in influenza pneumonia: rates, pathogens, and outcomes.
Among patients hospitalized for influenza pneumonia, the researchers reported the rate of coinfection and distribution of pathogens and also compared outcomes of patients with and without bacterial coinfection. They found that, in a large US inpatient sample hospitalized with influenza and community-acquired pneumonia, Staphylococcus aureus was the most frequent cause of bacterial coinfection. Coinfection was associated with worse outcomes and higher costs.
AHRQ-funded; HS024277.
Citation: Bartley PS, Deshpande A, Yu PC .
Bacterial coinfection in influenza pneumonia: rates, pathogens, and outcomes.
Infect Control Hosp Epidemiol 2022 Feb;43(2):212-17. doi: 10.1017/ice.2021.96..
Keywords: Influenza, Pneumonia, Infectious Diseases, Community-Acquired Infections
Rastogi R, Yu PC, Deshpande A
Treatment and outcomes among patients ≥85 years hospitalized with community-acquired pneumonia.
This retrospective cohort study’s objective was to describe community-acquired pneumonia (CAP) among patients ≥85 years and compare them to patients aged 65-74. Findings showed that patients aged 85 and over have different comorbidities and etiologies of CAP, receive less intense treatment, and have greater mortality than patients between 65 and 75 years.
AHRQ-funded; HS024277.
Citation: Rastogi R, Yu PC, Deshpande A .
Treatment and outcomes among patients ≥85 years hospitalized with community-acquired pneumonia.
J Investig Med 2022 Feb;70(2):376-82. doi: 10.1136/jim-2021-002078..
Keywords: Elderly, Community-Acquired Infections, Pneumonia, Outcomes, Hospitalization
Haessler S, Lindenauer PK, Zilberberg MD
Blood cultures versus respiratory cultures: 2 different views of pneumonia.
This study examined characteristics and outcomes of patients with positive cultures for pneumonia by site. The authors compared results from blood and respiratory cultures to see if organisms and resistance patterns differed by site. They studied adult patients discharged from July 2010 to June 2015 with principal diagnoses of pneumonia, respiratory failure, acute respiratory distress syndrome, respiratory arrest, or sepsis with a secondary diagnosis of pneumonia. Out of 138,651 hospitalizations of patients with pneumonia, 9.3% yielded positive cultures with 6438 from respiratory culture and 5992 blood cultures, and 45 both respiratory and blood cultures. Isolates from respiratory samples were often more resistant than were isolates from blood. Patients with positive cultures in both sites had higher case-fatality, longer lengths of stay and higher costs than patients who only had one culture site positive. Among respiratory cultures, the most common pathogens identified were Staphylococcus aureus (34%) and Pseudomonas aeruginosa (17%), whereas blood cultures most commonly grew Streptococcus pneumoniae (33%), followed by S. aureus (22%).
AHRQ-funded; HS024277.
Citation: Haessler S, Lindenauer PK, Zilberberg MD .
Blood cultures versus respiratory cultures: 2 different views of pneumonia.
Clin Infect Dis 2020 Oct 23;71(7):1604-12. doi: 10.1093/cid/ciz1049..
Keywords: Pneumonia, Community-Acquired Infections, Respiratory Conditions, Infectious Diseases
Schimmel JJ, Haessler S, Imrey P
Pneumococcal urinary antigen testing in United States hospitals: a missed opportunity for antimicrobial stewardship.
The Infectious Disease Society of America recommends pneumococcal urinary antigen testing (UAT) when identifying pneumococcal infection would allow for antibiotic de-escalation. However, the frequencies of UAT and subsequent antibiotic de-escalation are unknown. The authors conducted this retrospective cohort study of adult patients admitted with community-acquired or healthcare-associated pneumonia to 170 US hospitals in the Premier database from 2010-2015, to describe variation in UAT use, associations of UAT results with antibiotic de-escalation, and associations of de-escalation with outcomes.
AHRQ-funded; HS024277.
Citation: Schimmel JJ, Haessler S, Imrey P .
Pneumococcal urinary antigen testing in United States hospitals: a missed opportunity for antimicrobial stewardship.
Clin Infect Dis 2020 Sep 12;71(6):1427-34. doi: 10.1093/cid/ciz983..
Keywords: Antimicrobial Stewardship, Community-Acquired Infections, Infectious Diseases, Pneumonia
Obodozie-Ofoegbu OO, Teng C, Mortensen EM
Antipseudomonal monotherapy or combination therapy for older adults with community-onset pneumonia and multidrug-resistant risk factors: a retrospective cohort study.
Infectious Diseases Society of America guidelines recommend empiric antipseudomonal combination therapy when Pseudomonas is suspected. However, combination antipseudomonal therapy is controversial. This population-based retrospective cohort study compared all-cause 30-day mortality in older patients who received antipseudomonal monotherapy (PMT) or antipseudomonal combination therapy (PCT) for the treatment of community-onset pneumonia. The investigators found that older adults who received combination antipseudomonal therapy for community-onset pneumonia fared worse than those who received monotherapy.
AHRQ-funded; HS022418.
Citation: Obodozie-Ofoegbu OO, Teng C, Mortensen EM .
Antipseudomonal monotherapy or combination therapy for older adults with community-onset pneumonia and multidrug-resistant risk factors: a retrospective cohort study.
Am J Infect Control 2019 Sep;47(9):1053-58. doi: 10.1016/j.ajic.2019.02.018..
Keywords: Antibiotics, Community-Acquired Infections, Elderly, Infectious Diseases, Medication, Pneumonia, Risk
Asti L, Bartsch SM, Umscheid CA
The potential economic value of sputum culture use in patients with community-acquired pneumonia and healthcare-associated pneumonia.
Researchers developed a decision model to determine the economic and clinical value of using sputum cultures in the treatment of community-acquired pneumonia (CAP) and healthcare-associated pneumonia (HCAP) from the hospital perspective under various conditions. They found that, overall, obtaining sputum cultures does not provide significant clinical or economic benefits for CAP or HCAP patients; however, it can reduce costs and shorten overall length of stay under some circumstances. They recommended that clinicians consider their local conditions when making decisions about sputum culture use.
AHRQ-funded; HS023317.
Citation: Asti L, Bartsch SM, Umscheid CA .
The potential economic value of sputum culture use in patients with community-acquired pneumonia and healthcare-associated pneumonia.
Clin Microbiol Infect 2019 Aug;25(8):1038.e1-38.e9. doi: 10.1016/j.cmi.2018.11.031..
Keywords: Pneumonia, Community-Acquired Infections, Healthcare-Associated Infections (HAIs), Infectious Diseases, Healthcare Costs, Clinical Decision Support (CDS), Shared Decision Making
Gupta NM, Lindenauer PK, Yu PC
Association between alcohol use disorders and outcomes of patients hospitalized with community-acquired pneumonia.
The purpose of this study was to compare the causes, treatment, and outcomes of pneumonia in patients with and without alcohol use disorder (AUD). Results suggest that, compared with hospitalized patients with community-acquired pneumonia but without AUD, those with AUD less often harbor resistant organisms. The authors conclude that higher age-adjusted risk of death among patients with AUD appears to be largely attributable to differences in comorbidities, whereas greater use of health care resources may be attributable to alcohol withdrawal.
AHRQ-funded; HS024277; HS025026.
Citation: Gupta NM, Lindenauer PK, Yu PC .
Association between alcohol use disorders and outcomes of patients hospitalized with community-acquired pneumonia.
JAMA Netw Open 2019 Jun 5;2(6):e195172. doi: 10.1001/jamanetworkopen.2019.5172..
Keywords: Alcohol Use, Community-Acquired Infections, Hospitalization, Outcomes, Pneumonia, Substance Abuse
Leyenaar JK, Andrews CB, Tyksinski ER
Facilitators of interdepartmental quality improvement: a mixed-methods analysis of a collaborative to improve pediatric community-acquired pneumonia management.
This study examined the relationship between emergency room (ER) physicians and hospital pediatricians in the use of narrow-spectrum antibiotics to treat children hospitalized with pneumonia. There were eight inter-related domains that were identified that contribute to successful quality improvement efforts. These domains include hospital leadership and support; quality improvement champions, and interdepartmental relationships.
AHRQ-funded; HS024133; HS024554.
Citation: Leyenaar JK, Andrews CB, Tyksinski ER .
Facilitators of interdepartmental quality improvement: a mixed-methods analysis of a collaborative to improve pediatric community-acquired pneumonia management.
BMJ Qual Saf 2019 Mar;28(3):215-22. doi: 10.1136/bmjqs-2018-008065..
Keywords: Children/Adolescents, Community-Acquired Infections, Emergency Department, Pneumonia, Quality of Care, Quality Improvement
Frush JM, Zhu Y, Edwards KM
Prevalence of staphylococcus aureus and use of antistaphylococcal therapy in children hospitalized with pneumonia.
In a studied group of children hospitalized with community-acquired pneumonia, staphylococcal pneumonia was rare but associated with adverse in-hospital outcomes. Despite this low prevalence, use of antistaphylococcal antibiotics was common. The authors recommended efforts to minimize overuse of antistaphylococcal antibiotics while also ensuring adequate treatment for pathogen-specific diseases.
AHRQ-funded; HS022342.
Citation: Frush JM, Zhu Y, Edwards KM .
Prevalence of staphylococcus aureus and use of antistaphylococcal therapy in children hospitalized with pneumonia.
J Hosp Med 2018 Dec;13(12):848-52. doi: 10.12788/jhm.3093..
Keywords: Children/Adolescents, Infectious Diseases, Pneumonia, Methicillin-Resistant Staphylococcus aureus (MRSA), Community-Acquired Infections, Hospitalization, Antibiotics, Medication
Weir RE, Lyttle CS, Meltzer DO
The relative ability of comorbidity ascertainment methodologies to predict in-hospital mortality among hospitalized community-acquired pneumonia patients.
In this observational study, the investigators sought to compare the relative value of several methodologies by which comorbidities may be ascertained. The authors concluded that although comorbidities derived through administrative data did produce an area under the curve greater than chart review, their analyses suggested a coding bias in several comorbidities with a paradoxically protective effect. They assert that chart review, while labor and resource intensive, may be the ideal method for ascertainment of clinically relevant comorbidities.
AHRQ-funded; HS016948; HS010597.
Citation: Weir RE, Lyttle CS, Meltzer DO .
The relative ability of comorbidity ascertainment methodologies to predict in-hospital mortality among hospitalized community-acquired pneumonia patients.
Med Care 2018 Nov;56(11):950-55. doi: 10.1097/mlr.0000000000000989..
Keywords: Community-Acquired Infections, Hospitalization, Mortality, Pneumonia
Meystre S, Gouripeddi R, Tieder J
Enhancing comparative effectiveness research with automated pediatric pneumonia detection in a multi-institutional clinical repository: a PHIS+ pilot study.
The aim of this study was to develop an automated, scalable, and accurate method to determine the presence or absence of pneumonia in children using chest imaging reports. It found that, when compared with each of the domain experts manually annotating these reports, the new Natural Language Processing (NLP) application developed by the researchers allowed for significantly higher sensitivity (.71 vs .527) and similar positive predictive value and specificity.
AHRQ-funded; HS019862.
Citation: Meystre S, Gouripeddi R, Tieder J .
Enhancing comparative effectiveness research with automated pediatric pneumonia detection in a multi-institutional clinical repository: a PHIS+ pilot study.
J Med Internet Res 2017 May 15;19(5):e162. doi: 10.2196/jmir.6887.
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Keywords: Children/Adolescents, Community-Acquired Infections, Comparative Effectiveness, Health Information Technology (HIT), Pneumonia
Frei CR, Rehani S, Lee GC
Application of a risk score to identify older adults with community-onset pneumonia most likely to benefit from empiric pseudomonas therapy.
The researchers assessed the impact of empiric Pseudomonas pharmacotherapy on 30-day mortality in hospitalized patients with community-onset pneumonia stratified according to their risk (low, medium, or high) of drug-resistant pathogens. By using a risk score, they found that empiric Pseudomonas therapy was associated with lower 30-day mortality in the high-risk group but not the low- or medium-risk groups.
AHRQ-funded; HS022418.
Citation: Frei CR, Rehani S, Lee GC .
Application of a risk score to identify older adults with community-onset pneumonia most likely to benefit from empiric pseudomonas therapy.
Pharmacotherapy 2017 Feb;37(2):195-203. doi: 10.1002/phar.1891.
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Keywords: Elderly, Community-Acquired Infections, Pneumonia, Patient-Centered Outcomes Research, Risk
Belforti RK, Lagu T, Haessler S
Association between initial route of fluoroquinolone administration and outcomes in patients hospitalized for community-acquired pneumonia.
The objective of this study was to compare outcomes of hospitalized patients with community-acquired pneumonia receiving intravenous vs oral respiratory fluoroquinolones. The authors concluded that there was no association between initial route of administration and outcomes.
AHRQ-funded; HS018723.
Citation: Belforti RK, Lagu T, Haessler S .
Association between initial route of fluoroquinolone administration and outcomes in patients hospitalized for community-acquired pneumonia.
Clin Infect Dis 2016 Jul 1;63(1):1-9. doi: 10.1093/cid/ciw209.
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Keywords: Community-Acquired Infections, Pneumonia, Comparative Effectiveness, Patient-Centered Outcomes Research, Antibiotics
Parikh K, Hall M, Blaschke AJ
Aggregate and hospital-level impact of national guidelines on diagnostic resource utilization for children with pneumonia at children's hospitals.
Researchers sought to evaluate the temporal trends in diagnostic testing associated with guideline implementation among children with community-acquired pneumonia (CAP). They concluded that publication of national pneumonia guidelines in 2011 was associated with modest changes in diagnostic testing for children with CAP. However, the changes varied across hospitals, and the financial impact was modest.
AHRQ-funded; HS022342.
Citation: Parikh K, Hall M, Blaschke AJ .
Aggregate and hospital-level impact of national guidelines on diagnostic resource utilization for children with pneumonia at children's hospitals.
J Hosp Med 2016 May;11(5):317-23. doi: 10.1002/jhm.2534.
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Keywords: Children/Adolescents, Community-Acquired Infections, Guidelines, Pneumonia