Category: Antimicrobial Stewardship

Journal Club – Stewardship in Community Hospitals: How should we spend our limited resources? 

Stewardship in Community Hospitals: How should we spend our limited resources?  The following is a review by our ID Fellowship Program Director Dr. Trevor Van Schooneveld from our last Infection Control/Antimicrobial Stewardship Journal Club. He discussed the article by Anderson et al: Feasibility of Core Antimicrobial Stewardship Interventions in Community Hospitals. JAMA Network Open.  2019;2(8):e199369.   Antimicrobial stewardship is […]

Sep 9, 2019

UNMC IDSHEAroes #RaceAgainstResistance Fundraising Milestone Unlocked!

The Society for Healthcare Epidemiology of America (SHEA) is sponsoring the Race Against Resistance for the 4th year. Money raised is used to fund educational scholarships involved in treating, and researching, ways to prevent the 2050 predictions from coming true. This is a chance to take a stand against ‘superbugs’, to support those fighting against them today, to […]

Sep 3, 2019

Placing PICCs for Antibiotics – Potential Undue Risks May Outweight Benefits

PICC placement is common practice for intravenous (IV) antibiotic needs, however, we may be inadvertently placing certain patients at higher risks for complications. A recent study by Paje et al assessed the frequency of PICC placement among patients with CKD stage 3b or greater, a practice discordant with current guidelines. This prospective study included data […]

Jul 19, 2019

Inpatient Diarrheal Illness…Don’t Flush your Money: Save it with Diagnostic Stewardship!

Recently, a multidisciplinary team at UNMC published a diagnostic stewardship study in Infection Control & Hospital Epidemiology (ICHE) entitled: Hardwiring diagnostic stewardship using electronic ordering restrictions for gastrointestinal pathogen testing, that prompted a press release from The Society for Healthcare Epidemiology of America (SHEA), and a feature on an upcoming ICHE podcast episode. Drs. Jasmine Marcelin and Trevor Van […]

Jul 1, 2019

UNMC IDSHEAROES Enter the Race Against Resistance – Read Their Top Ten Reasons

Life-threatening infections caused by antimicrobial resistant organisms, commonly referred to as ‘superbugs’ have taken the media by storm. MRSA, VRE, MDRO, KPC, CRE, CDI – all acronyms that put fear in our hearts that one day, we will have run out of treatment options. That one day, our patients will die from infections that we […]

Jun 1, 2019

Do you really need to test the poo? Diagnostic stewardship for (outpatient) diarrheal illness

Rapid molecular testing has changed the landscape of diagnostic approaches to many infectious disease syndromes, including diarrheal illnesses. These panels typically have the capacity to diagnose multiple organisms in one test. The FilmArray gastrointestinal pathogen panel (BioFire) tests 22 stool pathogens. Despite the impact of improved clinical efficiency, these tests are often expensive, especially in […]

May 28, 2019

The Antimicrobial Stewardship Program: Keeper of the S. aureus bacteremia Checklist Manifesto

Staphylococcus aureus bacteremia (SAB) is a serious and sometimes devastating infection. There are established guidelines for optimal management, and more recently, numerous studies have shown the benefits of Infectious Diseases consultation, including improving guideline-adherent management, and reducing hospital stays, 30-day readmissions, and in-hospital mortality. Pharmacist-driven initiatives embedded within the Antimicrobial Stewardship Program (ASP) have also […]

May 10, 2019

When you see CRE: Add Equal Parts Antimicrobial Stewardship and Infection Control

The following was previously posted by Dr. Marcelin to SHEA Journal Club published online in April 2019. Dealing with carbapenem resistant organisms presents both an antimicrobial stewardship and infection control problem. Richter et al. aimed to predict risk factors for carbapenem resistance among Gram-negative rods (CR-GNR). The authors were particularly interested in whether differences exist […]

May 2, 2019

Does de-escalation of anti-MRSA therapy for culture-negative pneumonia affect patient outcomes?

Nosocomial pneumonia is a common hospital-acquired infection and has a high mortality rate in the critically ill.  Because drug-resistant bacteria like Pseudomonas aeruginosa and methicillin-resistant Staphylococcus aureus (MRSA) are commonly responsible for these infections, guidelines recommend broad-spectrum empirical therapy that includes anti-MRSA coverage.  Treatment is ideally de-escalated and refined based on culture results.  However, culture negative infections […]

Apr 22, 2019

What to Expect in Antimicrobial Stewardship…Shorter is Better, Of Course!

The following was previously posted by Dr. Marcelin to SHEA Journal Club published online in February 2019. Electronic clinical decision support tools and rapid diagnostic testing have significantly impacted the way we practice Infectious Diseases. Despite these scientific gains, Antimicrobial Stewardship still requires an understanding of the behavioral science of prescribing. Prior studies have demonstrated […]

Feb 26, 2019