National Healthcare Quality and Disparities Report
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Search All Research Studies
Topics
- Adverse Drug Events (ADE) (5)
- Adverse Events (4)
- Ambulatory Care and Surgery (1)
- (-) Antibiotics (9)
- Antimicrobial Stewardship (2)
- Children/Adolescents (1)
- Decision Making (1)
- Diagnostic Safety and Quality (1)
- Electronic Health Records (EHRs) (1)
- Evidence-Based Practice (1)
- Health Information Technology (HIT) (1)
- Intensive Care Unit (ICU) (1)
- Medication (9)
- (-) Medication: Safety (9)
- Patient-Centered Outcomes Research (1)
- Patient Safety (5)
- Quality Improvement (1)
- Quality of Care (1)
- Risk (2)
- Sepsis (1)
- Surgery (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 9 of 9 Research Studies DisplayedTan MS, Gomez-Lumbreras A, Villa-Zapata L
Colchicine and macrolides: a cohort study of the risk of adverse outcomes associated with concomitant exposure.
The authors conducted a cohort study using electronic health records comparing encounters with colchicine plus a macrolide and colchicine with an antibiotic non-macrolide, then assessed the relationship between the two groups. They found that heart failure was more frequent in the colchicine plus a macrolide cohort and that there was also a higher mortality rate. As there is a significant increase in the risk of hepatic failure and mortality when colchicine is concomitantly administered with a macrolide, they concluded that colchicine should not be used concomitantly with these antibiotics or should be temporarily discontinued to avoid toxic levels of colchicine.
AHRQ-funded; HS025984.
Citation: Tan MS, Gomez-Lumbreras A, Villa-Zapata L .
Colchicine and macrolides: a cohort study of the risk of adverse outcomes associated with concomitant exposure.
Rheumatol Int 2022 Dec;42(12):2253-59. doi: 10.1007/s00296-022-05201-5..
Keywords: Adverse Drug Events (ADE), Adverse Events, Medication, Risk, Antibiotics, Medication: Safety, Patient Safety
Sarfani S, Stone CA, Murphy GA
Understanding penicillin allergy, cross-reactivity, and antibiotic selection in the preoperative setting.
This study provided a review of the prevalence of penicillin allergy label (PAL), the cross-reactivity with cefazolin, immunogenic components of cefazolin and penicillin, and current guidelines for preoperative antibiotic selection in patients with PALs. On understanding these principles, a new set of guidelines and a risk stratification tool were proposed for assessing allergies and determining appropriate antibiotic choice, dosage, and timing in the orthopaedic preoperative setting.
AHRQ-funded; HS026395.
Citation: Sarfani S, Stone CA, Murphy GA .
Understanding penicillin allergy, cross-reactivity, and antibiotic selection in the preoperative setting.
J Am Acad Orthop Surg 2022 Jan;30(1):e1-e5. doi: 10.5435/jaaos-d-21-00422..
Keywords: Antibiotics, Medication, Medication: Safety
Krantz MS, Stone CA, Yu R
Criteria for intradermal skin testing and oral challenge in patients labeled as fluoroquinolone allergic.
This cohort study at Vanderbilt University looked at the utility of intradermal skin testing and oral challenge in patients labeled as fluoroquinolone (FQ) allergic. The authors concluded that most patients with non-anaphylactic immediate histories such as urticaria will tolerate single-dose 200- to 250-mg challenge with an FQ and further tolerate therapeutic courses of FQ. For patients with a history of anaphylaxis FQ, skin test positivity is needed using a distinct set of criteria.
AHRQ-funded; HS026395.
Citation: Krantz MS, Stone CA, Yu R .
Criteria for intradermal skin testing and oral challenge in patients labeled as fluoroquinolone allergic.
J Allergy Clin Immunol Pract 2021 Feb;9(2):1024-28.e3. doi: 10.1016/j.jaip.2020.09.017..
Keywords: Antibiotics, Medication: Safety, Medication, Adverse Drug Events (ADE), Adverse Events
Tamma PD, Miller MA, Cosgrove SE
AHRQ Author: Miller MA
Recalibrating our approach to the management of sepsis: how the four moments of antibiotic decision-making can help.
In this paper, the authors describe The Four Moments of Antibiotic Decision Making. The Four Moments were conceived as part of the Agency for Healthcare Research and Quality (AHRQ) Safety Program for Improving Antibiotic Use. The Four Moments provide a pragmatic approach to the core principle of antibiotic stewardship – ensuring patients who require antibiotic therapy promptly receive regimens associated with clinical success, while protecting patients from potential harm associated with unnecessary exposure to antibiotics.
AHRQ-authored; AHRQ-funded; 233201500020I.
Citation: Tamma PD, Miller MA, Cosgrove SE .
Recalibrating our approach to the management of sepsis: how the four moments of antibiotic decision-making can help.
Ann Am Thorac Soc 2021 Feb;18(2):200-03. doi: 10.1513/AnnalsATS.202005-484IP..
Keywords: Sepsis, Antibiotics, Antimicrobial Stewardship, Medication, Decision Making, Medication: Safety, Patient Safety
Alvarez-Arango S, Yerneni S, Tang O
Vancomycin hypersensitivity reactions documented in electronic health records.
This study’s objective is to describe vancomycin hypersensitivity reaction (HSR) epidemiology in hospitals documented in electronic health records. Vancomycin is the most commonly prescribed antimicrobial in US hospitals. A cross-sectional study of patients with 1 or more encounter from 2017 to 2019 and an electronic health record vancomycin drug allergy label (DAL) in 2 US health care systems was conducted. Prevalence and trends of vancomycin DALs and assessed active DALs by HSR phenotype was determined. Out of almost 4.5 million patients, 14,426 (0.3%) had a vancomycin DAL with 18,761 documented reactions. Out of those 18,761 vancomycin HSRs, 42.1% were immediate phenotypes and 20.7% were delayed phenotypes. Common reactions were rash and red man syndrome (RMS). Anaphylaxis occurred in 6% of HSRs. RMS reaction was more likely for males and less likely for Blacks.
AHRQ-funded; HS025375.
Citation: Alvarez-Arango S, Yerneni S, Tang O .
Vancomycin hypersensitivity reactions documented in electronic health records.
J Allergy Clin Immunol Pract 2021 Feb;9(2):906-12. doi: 10.1016/j.jaip.2020.09.027..
Keywords: Antibiotics, Medication, Medication: Safety, Electronic Health Records (EHRs), Health Information Technology (HIT), Adverse Drug Events (ADE), Adverse Events, Patient Safety
Stone CA, Stollings JL, Lindsell CJ
Risk-stratified management to remove low-risk penicillin allergy labels in the ICU.
Patients admitted to a medical ICU (MICU) often have chronic illnesses or altered immunity, increasing their need for immediate antibiotic use. In this study, the investigators sought to determine whether MICU patients with low-risk penicillin allergy history could be challenged directly with amoxicillin to have their allergy label safely removed during an acute inpatient stay.
Citation: Stone CA, Stollings JL, Lindsell CJ .
Risk-stratified management to remove low-risk penicillin allergy labels in the ICU.
Am J Respir Crit Care Med 2020 Jun 15;201(12):1572-75. doi: 10.1164/rccm.202001-0089LE..
Keywords: Intensive Care Unit (ICU), Antibiotics, Medication, Medication: Safety, Adverse Drug Events (ADE), Adverse Events, Risk, Diagnostic Safety and Quality
Rowe TA, Linder JA
Delayed antibiotic prescriptions in ambulatory care: reconsidering a problematic practice.
In this paper, the authors discuss delayed or backup antibiotic prescriptions, which are given to ambulatory patients with the expectation that the patient will pick up or fill the prescription if he or she is not improving within a few days. They discuss the drawbacks of delayed antibiotic prescriptions and the options for clinicians.
AHRQ-funded; HS024930; HS026506; 2332015000201.
Citation: Rowe TA, Linder JA .
Delayed antibiotic prescriptions in ambulatory care: reconsidering a problematic practice.
JAMA 2020 May 12;323(18):1779-80. doi: 10.1001/jama.2020.2325..
Keywords: Antibiotics, Medication, Ambulatory Care and Surgery, Medication: Safety, Patient Safety, Antimicrobial Stewardship
Ban KA, Gibbons MM, Ko CY
Evidence review conducted for the Agency for Healthcare Research and Quality Safety Program for Improving
This evidence review was conducted for AHRQ in partnership with the American College of Surgeons and the Johns Hopkins Armstrong Institute for Patient Safety and Quality who have developed the Safety Program for Improving Surgical Care and Recovery (ISCR). This national effort will disseminate best practices in perioperative care to more than 750 hospitals across multiple procedures in the next 5 years. This evidence-based review is focused on improving patient safety of anesthesiology for colorectal (CR) surgery. Components reviewed included carbohydrate loading, reduced fasting, multimodal preanesthesia medicine, antibiotic prophylaxis, normothermia, blood transfusion, intraoperative fluid management/goal-directed fluid therapy, a standardized intraoperative anesthesia pathway, and standard postoperative multimodal analgesic regiments. The results of this review will be used to develop an evidence-based CR protocol for implementation.
AHRQ-funded; 233201500020I.
Citation: Ban KA, Gibbons MM, Ko CY .
Evidence review conducted for the Agency for Healthcare Research and Quality Safety Program for Improving
Anesth Analg 2019 May;128(5):879-89. doi: 10.1213/ane.0000000000003366..
Keywords: Evidence-Based Practice, Surgery, Quality Improvement, Quality of Care, Patient Safety, Patient-Centered Outcomes Research, Antibiotics, Medication, Medication: Safety
Downes KJ, Goldstein SL, Vinks AA
Increased vancomycin exposure and nephrotoxicity in children: therapeutic does not mean safe.
The authors argue that a tenuous balance exists between the successful treatment of infection and the safe administration of vancomycin in the most vulnerable patients. Furthermore, prospective controlled trials are needed to identify and validate the optimal pharmacokinetic/pharmacodynamic (PK/PD) targets for vancomycin in children. Also, infectious diseases specialists need to be cognizant of the untoward effects of nephrotoxic acute kidney injury in children.
AHRQ-funded; HS021114.
Citation: Downes KJ, Goldstein SL, Vinks AA .
Increased vancomycin exposure and nephrotoxicity in children: therapeutic does not mean safe.
J Pediatric Infect Dis Soc 2016 Mar;5(1):65-7. doi: 10.1093/jpids/piu122.
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Keywords: Adverse Drug Events (ADE), Antibiotics, Children/Adolescents, Medication, Medication: Safety