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  1. Article ; Online: Effect of Pharmacist Audit on Antibiotic Duration for Pneumonia and Urinary Tract Infection.

    Thomas, Ashley A / Korienek, Patrick J / Reid, Stacy A / Dierkhising, Ross A / Dababneh, Ala S / Lessard, Sarah R

    Mayo Clinic proceedings. Innovations, quality & outcomes

    2021  Volume 5, Issue 4, Page(s) 763–769

    Abstract: Objective: To assess the effect of clinical pharmacists in daily audits, under the direction of an antimicrobial stewardship program, of antibiotic treatment durations for the common inpatient disease states of community-acquired pneumonia (CAP) and ... ...

    Abstract Objective: To assess the effect of clinical pharmacists in daily audits, under the direction of an antimicrobial stewardship program, of antibiotic treatment durations for the common inpatient disease states of community-acquired pneumonia (CAP) and urinary tract infection (UTI).
    Patients and methods: This was a retrospective single-center cohort study that evaluated the difference in the duration of antibiotic therapy for CAP or non-catheter-associated UTI of hospitalized patients who received a daily audit by clinical pharmacists compared with patients who did not receive a daily audit. Retrospective chart review included randomly selected hospitalized patients diagnosed with CAP or UTI during preaudit and postaudit periods.
    Results: The preaudit group had 64 patients; and the postaudit group, 51 patients. The therapy duration was 7 days in the preaudit group and 6 days in the postaudit group (
    Conclusion: The daily audits of clinical pharmacists may be an effective method to reduce the duration of antibiotic therapy and are effective in the reduction of fluoroquinolone use. Additional studies must be done to further investigate the effects of clinical pharmacist antimicrobial stewardship efforts.
    Language English
    Publishing date 2021-07-26
    Publishing country Netherlands
    Document type Journal Article
    ISSN 2542-4548
    ISSN (online) 2542-4548
    DOI 10.1016/j.mayocpiqo.2021.06.007
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Effect of β-Lactam Plus Macrolide Versus Fluoroquinolone on 30-Day Readmissions for Community-Acquired Pneumonia.

    Gilbert, Travis T / Arfstrom, Rachel J / Mihalovic, Scott W / Dababneh, Ala S / Varatharaj Palraj, Bharath Raj / Dierkhising, Ross A / Mara, Kristin C / Lessard, Sarah R

    American journal of therapeutics

    2018  Volume 27, Issue 2, Page(s) e177–e182

    Abstract: Background: Antibiotic therapy with a macrolide and β-lactam or a fluoroquinolone for the empirical treatment of community-acquired pneumonia (CAP) in an inpatient non-intensive care setting is recommended per guidelines. Studies show that these ... ...

    Abstract Background: Antibiotic therapy with a macrolide and β-lactam or a fluoroquinolone for the empirical treatment of community-acquired pneumonia (CAP) in an inpatient non-intensive care setting is recommended per guidelines. Studies show that these treatments have similar outcomes, including death, adverse effects, and bacterial eradication. However, a comparison of 30-day readmission rates between these treatments is limited.
    Study question: To determine whether 30-day readmissions for patients treated for CAP in a regional hospital differed between a fluoroquinolone monotherapy and a β-lactam plus macrolide combination therapy.
    Study design: Retrospective cohort study of patients aged ≥18 years with a CAP diagnosis who were admitted to the same regional hospital from December 1, 2011, through December 1, 2016.
    Measures and outcomes: Patients receiving a third-generation cephalosporin plus macrolide were compared with those receiving a respiratory fluoroquinolone. Exclusion criteria were concurrent or recent use of the study antibiotics; death, transfer, or transition to hospice; and diagnosis of hospital-acquired pneumonia or health care-associated pneumonia. The collected data were 30-day readmission rates, antibiotic regimens, demographic characteristics, and pneumonia severity index and comorbidity scores. Association between treatment group and readmissions was assessed with logistic regression. Association between readmissions and individual data points between the 2 treatment groups was calculated with multivariate regression and odds ratio (95% confidence interval).
    Results: Of 432 patients, 171 met inclusion criteria (fluoroquinolone group, n = 101; β-lactam plus macrolide group, n = 70). Thirty-day readmissions were not significantly different between the fluoroquinolone group and β-lactam plus macrolide group (P = 0.58). Increased 30-day readmissions were independently associated with male sex and hospital length of stay (P < 0.05). Length of stay was approximately 3 days and did not differ between treatment groups.
    Conclusions: No difference was seen in 30-day readmissions between CAP patients who received fluoroquinolone monotherapy and those who received β-lactam plus macrolide combination therapy.
    MeSH term(s) Aged ; Aged, 80 and over ; Anti-Bacterial Agents/therapeutic use ; Cephalosporins/therapeutic use ; Cohort Studies ; Community-Acquired Infections/drug therapy ; Community-Acquired Infections/mortality ; Drug Therapy, Combination ; Female ; Fluoroquinolones/therapeutic use ; Humans ; Length of Stay ; Macrolides/therapeutic use ; Male ; Middle Aged ; Patient Readmission/statistics & numerical data ; Pneumonia, Bacterial/drug therapy ; Pneumonia, Bacterial/mortality ; Sex Characteristics ; Treatment Outcome ; beta-Lactams/therapeutic use
    Chemical Substances Anti-Bacterial Agents ; Cephalosporins ; Fluoroquinolones ; Macrolides ; beta-Lactams
    Language English
    Publishing date 2018-11-13
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1280786-2
    ISSN 1536-3686 ; 1075-2765
    ISSN (online) 1536-3686
    ISSN 1075-2765
    DOI 10.1097/MJT.0000000000000788
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: A Framework for Outpatient Infusion of Antispike Monoclonal Antibodies to High-Risk Patients with Mild-to-Moderate Coronavirus Disease-19: The Mayo Clinic Model.

    Razonable, Raymund R / Aloia, Nicole C E / Anderson, Ryan J / Anil, Gokhan / Arndt, Lori L / Arndt, Richard F / Ausman, Sara E / Bell, Sarah J / Bierle, Dennis M / Billings, Marcie L / Bishop, Rachel K / Cramer, Carl H / Culbertson, Tracy L / Dababneh, Ala S / Derr, Amber N / Epps, Kevin / Flaker, Susan M / Ganesh, Ravindra / Gilmer, Mary A /
    Urena, Eric Gomez / Gulden, Christopher R / Haack, Tamara L / Hanson, Sara N / Herzog, Jenna R / Heyliger, Alexander / Hokanson, Lex D / Hopkins, Laura H / Horecki, Richard J / Krishna, Bipinchandra Hirisave / Huskins, W Charles / Jackson, Tammy A / Johnson, Ryan R / Jorgenson, Betty / Kudrna, Cory / Kennedy, Brian D / Klingsporn, Mary K / Kottke, Brian / Larsen, Jennifer J / Lessard, Sarah R / Lutwick, Larry I / Malone, Edward J / Matoush, Jennifer A / Micallef, Ivana N / Moehnke, Darcie E / Mohamed, Muhanad / Ness, Colleena N / Olson, Shelly M / Orenstein, Robert / Palraj, Raj / Patel, Janki / Paulson, Damian J / Phelan, David / Peinovich, Margaret T / Ramsey, Wilford L / Rau-Kane, Taunya J / Reid, Kevin I / Reinschmidt, Karen J / Seville, Maria Teresa / Skold, Erin C / Smith, Jill M / Speicher, Leigh L / Spielman, Laurie A / Springer, Donna J / Sweeten, Perry W / Tempelis, Jennifer M / Tulledge-Scheitel, Sidna / Vergidis, Paschalis / Whipple, Daniel C / Wilker, Caroline G / Destro Borgen, Molly J

    Mayo Clinic proceedings

    2021  Volume 96, Issue 5, Page(s) 1250–1261

    Abstract: The administration of spike monoclonal antibody treatment to patients with mild to moderate COVID-19 is very challenging. This article summarizes essential components and processes in establishing an effective spike monoclonal antibody infusion program. ... ...

    Abstract The administration of spike monoclonal antibody treatment to patients with mild to moderate COVID-19 is very challenging. This article summarizes essential components and processes in establishing an effective spike monoclonal antibody infusion program. Rapid identification of a dedicated physical infrastructure was essential to circumvent the logistical challenges of caring for infectious patients while maintaining compliance with regulations and ensuring the safety of our personnel and other patients. Our partnerships and collaborations among multiple different specialties and disciplines enabled contributions from personnel with specific expertise in medicine, nursing, pharmacy, infection prevention and control, electronic health record (EHR) informatics, compliance, legal, medical ethics, engineering, administration, and other critical areas. Clear communication and a culture in which all roles are welcomed at the planning and operational tables are critical to the rapid development and refinement needed to adapt and thrive in providing this time-sensitive beneficial therapy. Our partnerships with leaders and providers outside our institutions, including those who care for underserved populations, have promoted equity in the access of monoclonal antibodies in our regions. Strong support from institutional leadership facilitated expedited action when needed, from a physical, personnel, and system infrastructure standpoint. Our ongoing real-time assessment and monitoring of our clinical program allowed us to improve and optimize our processes to ensure that the needs of our patients with COVID-19 in the outpatient setting are met.
    MeSH term(s) Antibodies, Monoclonal/administration & dosage ; Antiviral Agents/administration & dosage ; COVID-19/epidemiology ; COVID-19/therapy ; Clinical Protocols ; Critical Pathways/organization & administration ; Critical Pathways/trends ; Efficiency, Organizational ; Home Infusion Therapy/methods ; Home Infusion Therapy/standards ; Humans ; Intersectoral Collaboration ; Organizational Culture ; Program Development/methods ; SARS-CoV-2/immunology ; SARS-CoV-2/isolation & purification ; Severity of Illness Index ; Spike Glycoprotein, Coronavirus/antagonists & inhibitors ; Spike Glycoprotein, Coronavirus/immunology ; United States/epidemiology
    Chemical Substances Antibodies, Monoclonal ; Antiviral Agents ; Spike Glycoprotein, Coronavirus ; spike protein, SARS-CoV-2
    Language English
    Publishing date 2021-03-09
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 124027-4
    ISSN 1942-5546 ; 0025-6196
    ISSN (online) 1942-5546
    ISSN 0025-6196
    DOI 10.1016/j.mayocp.2021.03.010
    Database MEDical Literature Analysis and Retrieval System OnLINE

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