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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (1)
- Adverse Events (2)
- Ambulatory Care and Surgery (1)
- (-) Antibiotics (33)
- Antimicrobial Stewardship (12)
- Cancer (2)
- Cancer: Breast Cancer (1)
- Children/Adolescents (5)
- Clostridium difficile Infections (9)
- Comparative Effectiveness (2)
- Diagnostic Safety and Quality (1)
- Elderly (2)
- Evidence-Based Practice (2)
- Guidelines (3)
- (-) Healthcare-Associated Infections (HAIs) (33)
- Healthcare Costs (2)
- Hospitals (1)
- Imaging (1)
- Infectious Diseases (9)
- Injuries and Wounds (2)
- Inpatient Care (2)
- Intensive Care Unit (ICU) (1)
- Long-Term Care (2)
- Medication (22)
- Methicillin-Resistant Staphylococcus aureus (MRSA) (5)
- Nursing (1)
- Nursing Homes (2)
- Obesity (1)
- Outcomes (1)
- Patient-Centered Outcomes Research (2)
- Patient Safety (11)
- Pneumonia (2)
- Policy (1)
- Practice Patterns (5)
- Prevention (12)
- Respiratory Conditions (1)
- Risk (2)
- Shared Decision Making (1)
- Skin Conditions (1)
- Surgery (7)
- Treatments (1)
- Women (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 33 Research Studies DisplayedLiu S, Matvekas A, Naimi T
Morphomics-informed population pharmacokinetic and physiologically-based pharmacokinetic modeling to optimize cefazolin surgical prophylaxis.
This study’s objective was to use algorithms that repurpose radiologic data into body composition (morphomics) to aid in informing dosing decisions for the antibiotic cefazolin for patients undergoing colorectal surgery who have obesity. This prospective study measured cefazolin plasma, fat, and colon tissue concentrations in these patients to develop a morphomics-informed population pharmacokinetic (PopPK) model to guide dose adjustments. A physiologically-based pharmacokinetic (PBPK) model was also constructed to inform tissue partitioning in 21 morbidly obese patients (body mass index ≥35 kg/m2 with one or more co-morbid conditions). Morphomics and pharmacokinetic data were available in 58 patients with a median weight of 95.9 kg and and 55 years, respectively. The plasma-to-subcutaneous fat partition coefficient was predicted to be 0.072 for the PopPK model and 0.060 for the PBPK model. Covariates of cefazolin exposure were identified as the estimated creatinine clearance (eCL(cr) ) and body depth at the third lumbar vertebra (body depth_L3). The authors concluded that kidney function and morphomics were more informative than body weight as covariates of cefazolin target site exposure. They advised that data from more diverse populations, consensus on target cefazolin exposure, and comparative studies are needed before a change in practice can be implemented.
AHRQ-funded; HS027183.
Citation: Liu S, Matvekas A, Naimi T .
Morphomics-informed population pharmacokinetic and physiologically-based pharmacokinetic modeling to optimize cefazolin surgical prophylaxis.
Pharmacotherapy 2024 Jan; 44(1):77-86. doi: 10.1002/phar.2878..
Keywords: Surgery, Antibiotics, Medication, Prevention, Obesity, Healthcare-Associated Infections (HAIs)
Ojala F, Sater MRA, Miller LG
Bayesian modeling of the impact of antibiotic resistance on the efficiency of MRSA decolonization.
The authors analyzed how the persistence of methicillin-resistant Staphylococcus aureus (MRSA) colonization correlates with the genomic presence of antibiotic resistance genes. Using a Bayesian mixed effects survival model, they found that genetic determinants of high-level resistance to mupirocin was strongly associated with failure of the decolonization protocol, but they did not find a similar effect with genetic resistance to chlorhexidine or other antibiotics. They concluded that these results highlight the need to consider the properties of the colonizing MRSA strain when deciding which treatments to include in the decolonization protocol.
AHRQ-funded; HS019388.
Citation: Ojala F, Sater MRA, Miller LG .
Bayesian modeling of the impact of antibiotic resistance on the efficiency of MRSA decolonization.
PLoS Comput Biol 2023 Oct; 19(10):e1010898. doi: 10.1371/journal.pcbi.1010898..
Keywords: Antibiotics, Methicillin-Resistant Staphylococcus aureus (MRSA), Healthcare-Associated Infections (HAIs), Medication
Warren DK, Peacock KM, Nickel KB
Postdischarge prophylactic antibiotics following mastectomy with and without breast reconstruction.
The authors investigated factors associated with post-discharge prophylactic antibiotic use after mastectomy with and without immediate reconstruction and the impact on surgical-site infection (SSI). They found that anti-methicillin-sensitive Staphylococcus aureus antibiotics were associated with decreased risk of SSI for patients who had mastectomy only and those who had mastectomy with immediate reconstruction. They concluded that the high numbers needed to treat suggest that potential benefits of post-discharge antibiotics should be weighed against potential harms associated with antibiotic overuse.
AHRQ-funded; HS019455.
Citation: Warren DK, Peacock KM, Nickel KB .
Postdischarge prophylactic antibiotics following mastectomy with and without breast reconstruction.
Infect Control Hosp Epidemiol 2022 Oct;43(10):1382-88. doi: 10.1017/ice.2021.400..
Keywords: Antibiotics, Cancer: Breast Cancer, Cancer, Medication, Surgery, Healthcare-Associated Infections (HAIs), Prevention, Women, Practice Patterns
Safdar N, Parmasad V, Brown R
Decreasing ICU-associated Clostridioides difficile infection through fluoroquinolone restriction, the FIRST trial: a study protocol.
Clostridioides difficile infection (CDI) is one of the most common healthcare-associated infections in the USA, having high incidence in intensive care units (ICU). Antibiotic use increases risk of CDI, with fluoroquinolones (FQs) particularly implicated. In healthcare settings, antibiotic stewardship (AS) and infection control interventions are effective in CDI control, but there is little evidence regarding the most effective AS interventions. In this paper the investigators describe their multisite, stepped-wedge, cluster, effectiveness-implementation clinical trial.
AHRQ-funded; R01 HS026226.
Citation: Safdar N, Parmasad V, Brown R .
Decreasing ICU-associated Clostridioides difficile infection through fluoroquinolone restriction, the FIRST trial: a study protocol.
BMJ Open 2021 Jun 29;11(6):e046480. doi: 10.1136/bmjopen-2020-046480..
Keywords: Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Intensive Care Unit (ICU), Antimicrobial Stewardship, Antibiotics, Medication, Prevention
Brajcic BC, Ko CY, Liu JB
A NSQIP-based randomized clinical trial evaluating choice of prophylactic antibiotics for pancreaticoduodenectomy.
This paper describes the protocol for an upcoming multicenter randomized surgical trial to evaluate choice of prophylactic antibiotics for pancreaticoduodenectomy. The rationale and methodology of the trial evaluating piperacillin-tazobactam compared to cefoxitin for surgical site infection prevention is described. The study will utilize a clinical registry for data collection.
AHRQ-funded; HS000078.
Citation: Brajcic BC, Ko CY, Liu JB .
A NSQIP-based randomized clinical trial evaluating choice of prophylactic antibiotics for pancreaticoduodenectomy.
J Surg Oncol 2021 May;123(6):1387-94. doi: 10.1002/jso.26402..
Keywords: Cancer, Antibiotics, Medication, Prevention, Surgery, Healthcare-Associated Infections (HAIs), Comparative Effectiveness, Evidence-Based Practice
Deshpande A, Richter SS, Haessler S
De-escalation of empiric antibiotics following negative cultures in hospitalized patients with pneumonia: rates and outcomes.
This study assessed antibiotic de-escalation practices across hospitals and their associations with outcomes in hospitalized patients diagnosed with pneumonia with negative cultures. The authors included 14,170 adults admitted with pneumonia in 2010-2015 to 164 US hospitals if they had negative blood and/or respiratory cultures and received both anti-MRSA and antipseudomonal agents other than quinolones. If empiric drugs were stopped on day 4 while continuing another antibiotic it was defined at de-escalation. Patients were propensity adjusted for de-escalation and compared on in-hospital 14-day mortality, late deterioration with ICU transfer, length-of-stay (LOS) and costs. Thirteen percent (1924 patients) had both initial empiric drugs stopped by hospital day 4. De-escalation rates at hospitals ranged from 2-35% and the established rate quartiles were not significantly associated with outcomes. Even at hospitals in the top quartile of de-escalation, the de-escalation rates were lower than 50%.
AHRQ-funded; HS025026; HS024277.
Citation: Deshpande A, Richter SS, Haessler S .
De-escalation of empiric antibiotics following negative cultures in hospitalized patients with pneumonia: rates and outcomes.
Clin Infect Dis 2021 Apr 26;72(8):1314-22. doi: 10.1093/cid/ciaa212..
Keywords: Antimicrobial Stewardship, Antibiotics, Medication, Pneumonia, Respiratory Conditions, Methicillin-Resistant Staphylococcus aureus (MRSA), Healthcare-Associated Infections (HAIs), Inpatient Care
Bowman JA, Utter GH
Evolving strategies to manage Clostridium difficile colitis.
The authors discuss Clostridium difficile infection and diagnostic methods and treatment strategies evolved in recent years. They indicate that oral or enteral vancomycin is now preferred for first-line antimicrobial treatment across the disease spectrum, including mild to moderate initial cases. Further, fidaxomicin, bezlotoxumab, and fecal microbiota transplantation expand the therapeutic armamentarium, with operative treatment being reserved for patients with fulminant infection. They add that early identification of patients who would benefit from an operation remains a challenge.
AHRQ-funded; HS022236.5rf2c
Citation: Bowman JA, Utter GH .
Evolving strategies to manage Clostridium difficile colitis.
J Gastrointest Surg 2020 Feb;24(2):484-91. doi: 10.1007/s11605-019-04478-5..
Keywords: Clostridium difficile Infections, Infectious Diseases, Healthcare-Associated Infections (HAIs), Antibiotics, Medication, Treatments
Chiotos K, Rock C, Schweizer ML
Current infection prevention and antibiotic stewardship program practices: a survey of the Society for Healthcare Epidemiology of America (SHEA) Research Network (SRN).
This survey compares results with a similar 2013 survey that characterizes contemporary infection prevention and antibiotic stewardship program practices across 64 healthcare facilities. There was decreased frequency of active surveillance for MRSA, frequent active surveillance for carbapenem-resistant Enterobacteriaceae, and increased support for antibiotic stewardship programs.
AHRQ-funded; HS026393.
Citation: Chiotos K, Rock C, Schweizer ML .
Current infection prevention and antibiotic stewardship program practices: a survey of the Society for Healthcare Epidemiology of America (SHEA) Research Network (SRN).
Infect Control Hosp Epidemiol 2019 Sep;40(9):1046-49. doi: 10.1017/ice.2019.172.
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Keywords: Antimicrobial Stewardship, Antibiotics, Medication, Methicillin-Resistant Staphylococcus aureus (MRSA), Healthcare-Associated Infections (HAIs), Infectious Diseases, Prevention, Practice Patterns
Khamash DF, Voskertchian A, Tamma PD
Increasing clindamycin and trimethoprim-sulfamethoxazole resistance in pediatric Staphylococcus aureus Infections.
This retrospective observational study looked at pediatric clinical cultures between 2005 and 2017 that grew Staphylococcus aureus culture and their trends in antibiotic resistance. Methicillin resistance declined but clindamycin and trimethoprim-sulfamethoxazole resistance increased significantly.
AHRQ-funded; HS022872.
Citation: Khamash DF, Voskertchian A, Tamma PD .
Increasing clindamycin and trimethoprim-sulfamethoxazole resistance in pediatric Staphylococcus aureus Infections.
J Pediatric Infect Dis Soc 2019 Sep 25;8(4):351-53. doi: 10.1093/jpids/piy062..
Keywords: Children/Adolescents, Antibiotics, Medication, Healthcare-Associated Infections (HAIs), Infectious Diseases, Methicillin-Resistant Staphylococcus aureus (MRSA)
Khamash DF, Voskertchian A, Tamma PD
Increasing clindamycin and trimethoprim-sulfamethoxazole resistance in pediatric Staphylococcus aureus Infections.
This retrospective observational study looked at pediatric clinical cultures between 2005 and 2017 that grew Staphylococcus aureus culture and their trends in antibiotic resistance. Methicillin resistance declined but clindamycin and trimethoprim-sulfamethoxazole resistance increased significantly.
AHRQ-funded; HS022872.
Citation: Khamash DF, Voskertchian A, Tamma PD .
Increasing clindamycin and trimethoprim-sulfamethoxazole resistance in pediatric Staphylococcus aureus Infections.
J Pediatric Infect Dis Soc 2019 Sep 25;8(4):351-53. doi: 10.1093/jpids/piy062..
Keywords: Children/Adolescents, Healthcare-Associated Infections (HAIs), Antibiotics, Medication
Anderson DJ, Watson S, Moehring RW
Feasibility of core antimicrobial stewardship interventions in community hospitals.
The purpose of this study was to determine the feasibility and results of implementing 2 core stewardship intervention strategies in community hospitals. The two antimicrobial stewardship strategies targeted vancomycin hydrochloride, piperacillin-tazobactam, and the antipseudomonal carbapenems on formulary at the study hospitals: (1) modified preauthorization (PA), in which the prescriber had to receive pharmacist approval for continued use of the antibiotic after the first dose, and (2) postprescription audit and review (PPR), in which the pharmacist would engage the prescriber about antibiotic appropriateness after 72 hours of therapy.
AHRQ-funded; HS023866.
Citation: Anderson DJ, Watson S, Moehring RW .
Feasibility of core antimicrobial stewardship interventions in community hospitals.
The purpose of this study was to determine the feasibility and results of implementing 2 core stewardship intervention strategies in community hospitals. The two antimicrobial stewardship strategies targeted vancomycin hydrochloride, piperacillin-tazobactam, and the antipseudomonal carbapenems on formulary at the study hospitals: (1) modified preauthorization (PA), in which the prescriber had to receive pharmacist approval for continued use of the antibiotic after the first dose, and (2) postprescription audit and review (PPR), in which the pharmacist would engage the prescriber about antibiotic appropriateness after 72 hours of therapy..
Keywords: Antibiotics, Antimicrobial Stewardship, Healthcare-Associated Infections (HAIs), Hospitals, Infectious Diseases, Medication, Patient Safety
Caroff DA, Menchaca JT, Zhang Z
Oral vancomycin prophylaxis during systemic antibiotic exposure to prevent Clostridiodes difficile infection relapses.
This study’s goal was to determine if giving hospitalized patients oral vancomycin along with systematic antibiotics prevents relapse of Cloistridioides difficile infection (CDI). The results show that the outcome was not statistically significant, although it may help patients who have only had 1 prior CDI episode.
AHRQ-funded; HS025008.
Citation: Caroff DA, Menchaca JT, Zhang Z .
Oral vancomycin prophylaxis during systemic antibiotic exposure to prevent Clostridiodes difficile infection relapses.
Infect Control Hosp Epidemiol 2019 Jun;40(6):662-67. doi: 10.1017/ice.2019.88..
Keywords: Antibiotics, Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Medication, Prevention
Monsees EA, Tamma PD, Cosgrove SE
AHRQ Author: Miller MA
Integrating bedside nurses into antibiotic stewardship: a practical approach.
This study looked into a framework for nurses to integrate antibiotic stewardship (AS) into their clinical work with patients. The practices that nurses can take include improving antibiotic prescribing practices through appropriate obtainment of Cloistridioides difficile tests, appropriate urine culturing practices, optimal antibiotic administration, accurate and detailed documentation of antibiotic allergy histories, and through the prompting of antibiotic time outs. Barriers were also identified to engagement of nurses in AS and offered potential solutions.
AHRQ-authored; AHRQ-funded; 233201500020I.
Citation: Monsees EA, Tamma PD, Cosgrove SE .
Integrating bedside nurses into antibiotic stewardship: a practical approach.
Infect Control Hosp Epidemiol 2019 May;40(5):579-84. doi: 10.1017/ice.2018.362..
Keywords: Antibiotics, Antimicrobial Stewardship, Guidelines, Healthcare-Associated Infections (HAIs), Medication, Nursing, Patient Safety
Schneider JG, Wood JB, Schmitt BH
Susceptibility Provision Enhances Effective De-escalation (SPEED): utilizing rapid phenotypic susceptibility testing in Gram-negative bloodstream infections and its potential clinical impact.
In this study, the investigators evaluated the performance and time to result for pathogen identification (ID) and antimicrobial susceptibility testing (AST) of the Accelerate Pheno system (AXDX) compared with standard of care (SOC) methods. They also assessed the hypothetical improvement in antibiotic utilization if AXDX had been implemented. The authors indicated that by providing fast and reliable ID and AST results, AXDX has the potential to improve antimicrobial utilization and enhance antimicrobial stewardship.
AHRQ-funded; HS026390.
Citation: Schneider JG, Wood JB, Schmitt BH .
Susceptibility Provision Enhances Effective De-escalation (SPEED): utilizing rapid phenotypic susceptibility testing in Gram-negative bloodstream infections and its potential clinical impact.
J Antimicrob Chemother 2019 Jan;74(Suppl 1):i16-i23. doi: 10.1093/jac/dky531..
Keywords: Healthcare-Associated Infections (HAIs), Infectious Diseases, Antibiotics, Medication, Diagnostic Safety and Quality
Kline SE, Sanstead EC, Johnson JR
Cost-effectiveness of pre-operative Staphylococcus aureus screening and decolonization.
In this study, the investigators developed a decision analytic model to evaluate the impact of a preoperative Staphylococcus aureus decolonization bundle on surgical site infections (SSIs), health-care-associated costs (HCACs), and deaths due to SSI. The investigators predict that the treat-all strategy would be the most effective and cost-saving strategy for preventing SSIs. However, they concluded that because this strategy might select more extensively for mupirocin-resistant S. aureus and cause more medication adverse effects than the test-and-treat approach or the SOC, additional studies are needed to define its comparative benefits and harms.
AHRQ-funded; HS022912.
Citation: Kline SE, Sanstead EC, Johnson JR .
Cost-effectiveness of pre-operative Staphylococcus aureus screening and decolonization.
Infect Control Hosp Epidemiol 2018 Nov;39(11):1340-46. doi: 10.1017/ice.2018.228..
Keywords: Surgery, Antibiotics, Antimicrobial Stewardship, Healthcare-Associated Infections (HAIs), Infectious Diseases, Patient Safety, Prevention, Healthcare Costs
D'Agata EMC, Tran D, Bautista J
Clinical and economic benefits of antimicrobial stewardship programs in hemodialysis facilities: a decision analytic model.
In this study, the authors developed a decision analytic model of antimicrobial use on the clinical and economic consequences of implementing a nationwide antimicrobial stewardship program in outpatient dialysis facilities. The authors found that the model suggested that implementation of antimicrobial stewardship programs in outpatient dialysis facilities would result in substantial reductions in infections caused by multidrug-resistant organisms and C. difficile, infection-related deaths, and costs.
AHRQ-funded; R18 HS021666.
Citation: D'Agata EMC, Tran D, Bautista J .
Clinical and economic benefits of antimicrobial stewardship programs in hemodialysis facilities: a decision analytic model.
Clin J Am Soc Nephrol 2018 Sep 7;13(9):1389-97. doi: 10.2215/cjn.12521117..
Keywords: Antimicrobial Stewardship, Shared Decision Making, Antibiotics, Medication, Healthcare Costs, Clostridium difficile Infections, Healthcare-Associated Infections (HAIs)
Murray MT, Johnson CL, Cohen B
Use of antibiotics in paediatric long-term care facilities.
The authors sought to describe antibiotic use in three pediatric long-term care (LTC) facilities and to describe the factors associated with use. They found that the use of antibiotics in pediatric LTC facilities is widespread. They recommended further assessment of antibiotic use in pediatric LTC facilities.
AHRQ-funded; HS021470.
Citation: Murray MT, Johnson CL, Cohen B .
Use of antibiotics in paediatric long-term care facilities.
J Hosp Infect 2018 Jun;99(2):139-44. doi: 10.1016/j.jhin.2017.10.019.
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Keywords: Antibiotics, Children/Adolescents, Healthcare-Associated Infections (HAIs), Long-Term Care, Practice Patterns
McBride S, Thurm C, Gouripeddi R
Comparison of empiric antibiotics for acute osteomyelitis in children.
Broad-spectrum antibiotics are commonly used for the empiric treatment of acute hematogenous osteomyelitis and often target methicillin-resistant Staphylococcus aureus (MRSA) with medication-associated risk and unknown treatment benefit. In this study, the investigators aimed to compare clinical outcomes among patients with osteomyelitis who did and did not receive initial antibiotics used to target MRSA. The investigators found that, early antibiotic treatment used to target MRSA was associated with a higher rate of repeat MRI.
AHRQ-funded; HS019862.
Citation: McBride S, Thurm C, Gouripeddi R .
Comparison of empiric antibiotics for acute osteomyelitis in children.
Hosp Pediatr 2018 May;8(5):280-87. doi: 10.1542/hpeds.2017-0079..
Keywords: Children/Adolescents, Antibiotics, Methicillin-Resistant Staphylococcus aureus (MRSA), Healthcare-Associated Infections (HAIs), Medication, Imaging, Patient Safety
Johnson SP, Zhong L, Chung KC
Perioperative antibiotics for clean hand surgery: a national study.
This research is a national study on the use of prophylactic antibiotics in soft tissue hand surgery when antimicrobials are not indicated. Insurance claims from the Truven MarketScan Databases were used to identify patients who had 1 of 5 outpatient surgery procedures including: open or endoscopic carpal tunnel release; trigger finger release; de Ouervain release, and wrist ganglion excision between 2009 and 2015. An increase of 72.5% in prophylactic intravenous antibiotics was shown from 2009 to 2015. Patients with a younger age, male sex, lower income, or obesity had higher odds of receiving antibiotics. Total charge for these antibiotics equaled $1.6 million.
AHRQ-funded; HS023313.
Citation: Johnson SP, Zhong L, Chung KC .
Perioperative antibiotics for clean hand surgery: a national study.
J Hand Surg Am 2018 May;43(5):407-16.e1. doi: 10.1016/j.jhsa.2017.11.018..
Keywords: Antibiotics, Antimicrobial Stewardship, Healthcare-Associated Infections (HAIs), Infectious Diseases, Medication, Patient Safety, Surgery
D'Agata EMC
Addressing the problem of multidrug-resistant organisms in dialysis.
This review examined the problem of multi-drug resistant organisms in patients on maintenance hemodialysis. It is common problem in patients on hemodialysis, with rates of colonization of multi-drug resistant organisms ranging from 3% to over 20%. A prospective cohort study of patients was conducted in one outpatient dialysis unit. The acquisition of these organisms occurred in 40% of patients, with 13% and 15% of patients acquiring MRSA and VRE respectively. Contamination came from dialysis machines and chairs, and also believed to come from healthcare workers as well. The study recommends implementing antimicrobial stewardship programs to improve antimicrobial prescribing patterns and decreasing health care costs. AHRQ is one of the agencies involved in this promotion and research effort.
AHRQ-funded; HS021666.
Citation: D'Agata EMC .
Addressing the problem of multidrug-resistant organisms in dialysis.
Clin J Am Soc Nephrol 2018 Apr 6;13(4):666-68. doi: 10.2215/cjn.13781217..
Keywords: Antimicrobial Stewardship, Antibiotics, Medication, Healthcare-Associated Infections (HAIs)
Jump RLP, Crnich CJ, Mody L
Infectious diseases in older adults of long-term care facilities: update on approach to diagnosis and management.
The diagnosis, treatment, and prevention of infectious diseases in older adults in long-term care facilities (LTCFs), particularly nursing facilities, remains a challenge for all health providers who care for this population. This review provides updated information on the currently most important challenges of infectious diseases in LTCFs. With the increasing prescribing of antibiotics in older adults, particularly in LTCFs, the topic of antibiotic stewardship is presented in this review.
AHRQ-funded; HS022465.
Citation: Jump RLP, Crnich CJ, Mody L .
Infectious diseases in older adults of long-term care facilities: update on approach to diagnosis and management.
J Am Geriatr Soc 2018 Apr;66(4):789-803. doi: 10.1111/jgs.15248.
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Keywords: Elderly, Healthcare-Associated Infections (HAIs), Infectious Diseases, Nursing Homes, Long-Term Care, Antimicrobial Stewardship, Antibiotics, Medication, Evidence-Based Practice, Guidelines
Hogan PG, Rodriguez M, Spenner AM
Impact of systemic antibiotics on staphylococcus aureus colonization and recurrent skin infection.
This study found that systemic antibiotics, as part of acute skin and soft tissue infection (SSTI) management in conjunction with incision and drainage, impacted S. aureus colonization, thus contributing to a decreased incidence of recurrent SSTI. The mechanism by which clindamycin differentially affects colonization and recurrent SSTI compared to trimethoprim-sulfamethoxazole (TMP-SMX) warrants further study.
AHRQ-funded; HS021736; HS024269.
Citation: Hogan PG, Rodriguez M, Spenner AM .
Impact of systemic antibiotics on staphylococcus aureus colonization and recurrent skin infection.
Clin Infect Dis 2018 Jan 6;66(2):191-97. doi: 10.1093/cid/cix754.
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Keywords: Antibiotics, Children/Adolescents, Healthcare-Associated Infections (HAIs), Patient Safety, Skin Conditions
Jump RLP, Gaur S, Katz MJ
Template for an antibiotic stewardship policy for post-acute and long-term care settings.
To support compliance with Centers for Medicare and Medicaid services (CMS) requirements and aid facilities in establishing a stewardship program, the Infection Advisory Committee at the American Medical Directors Association -The Society for Post-Acute and Long-Term Care Medicine, has developed an antibiotic stewardship policy template tailored to the long-term care setting. This paper describes that policy template.
AHRQ-funded; HS022465; HS023779.
Citation: Jump RLP, Gaur S, Katz MJ .
Template for an antibiotic stewardship policy for post-acute and long-term care settings.
J Am Med Dir Assoc 2017 Nov;18(11):913-20. doi: 10.1016/j.jamda.2017.07.018..
Keywords: Antibiotics, Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Policy, Prevention
Haessler S, Lagu T, Lindenauer PK
Treatment trends and outcomes in healthcare-associated pneumonia.
This retrospective cohort study assessed changes in hospital rates of concordant antibiotic use over time and their correlation with outcomes related to management of healthcare-associated pneumonia (HCAP). The study concluded that only 1 in 5 patients with risk factors for HCAP received treatment that was fully in accordance with guidelines, and many received community-acquired pneumonia (CAP) therapy instead.
AHRQ-funded; HS018723.
Citation: Haessler S, Lagu T, Lindenauer PK .
Treatment trends and outcomes in healthcare-associated pneumonia.
J Hosp Med 2017 Nov;12(11):886-91. doi: 10.12788/jhm.2877..
Keywords: Antibiotics, Elderly, Healthcare-Associated Infections (HAIs), Patient-Centered Outcomes Research, Pneumonia
Olsen MA, Nickel KB, Fraser VJ
Prevalence and predictors of postdischarge antibiotic use following mastectomy.
This study determined utilization, predictors, and outcomes of postdischarge prophylactic antibiotics after mastectomy with or without immediate breast reconstruction. The study conclude that prophylactic postdischarge antibiotics are commonly prescribed after mastectomy; immediate reconstruction is the strongest predictor. The authors recommended stewardship efforts in this population to limit continuation of prophylactic antibiotics after discharge are needed to limit antimicrobial resistance.
AHRQ-funded; HS019455.
Citation: Olsen MA, Nickel KB, Fraser VJ .
Prevalence and predictors of postdischarge antibiotic use following mastectomy.
Infect Control Hosp Epidemiol 2017 Sep;38(9):1048-54. doi: 10.1017/ice.2017.128.
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Keywords: Antibiotics, Healthcare-Associated Infections (HAIs), Medication, Patient Safety, Surgery, Injuries and Wounds, Prevention, Adverse Events, Risk