We need better trials on long-term oral suppressive antimicrobial therapy (SAT) in infective endocarditis. Respond regarding the cases where you typically prescribe SAT. academic.oup.com/ofid/advance-a…

Another nail in the vancomycin coffin. After accounting for laboratory testing, pharmacist management time, and costs associated with vancomycin associated AKI, daptomycin saved $166 per patient when used in place of vancomycin. academic.oup.com/ofid/advance-a…

Time to treatment >64 hrs (<3 days) in first occurrence, non-severe C. difficile infection ➡️ 4.6x higher odds of progression on to severe/fulminant disease in elderly patients. Think about the time to collect, test, review, and fill script. cambridge.org/core/journals/…

“Bad days at work are inevitable, just as some degree of frustration and ennui is bound to be a part of almost any job. But you need to pay attention to the extent and frequency of these feelings.” Here are some questions to ask yourself. hbr.org/2024/04/should…

Higher odds of penalty under CMSGov Hospital-Acquired Condition Reduction Program if: Major Teaching Hospital, Safety Net Hospital, Level 1 Trauma Center, and/or Hospital Located in New England. pubmed.ncbi.nlm.nih.gov/38363569/

Out today! Stewardship prompts to improve antibiotic selection for pneumonia & UTI - 2 INSPIRE RCTs - Reduced empiric extended-spectrum antibiotic use by 28.4% and 17.4% in hospitalized patients with pneumonia & UTI, respectively. jamanetwork.com/journals/jama/… jamanetwork.com/journals/jama/…

New #Breakpoints episode:

We invite you to the 1st ever meeting of The Tortured Stewards & Surgeons Department. Tune in to today’s episode to hear Drs. Patch Dellinger, DrTrishaPeel, and Michael Calderwood, MD, MPH discuss optimal management of perioperative antibiotics & prevention of SSI.

“Many people operate from the belief that there’s too much to do and they can’t afford to take a break. … Remember that you are a human and not a machine.” Great suggestions in this article. Give yourself permission to take a break. hbr.org/2024/03/dont-u…

I like this list of essential qualities of successful leaders: Authenticity, Curiosity, Analytical Prowess, Adaptability, Creativity, Comfort with Ambiguity, Resilience, and Empathy. hbr.org/2023/12/8-esse…

Nice APIC survey on infection prevention staffing co-written by Dartmouth Health’s Jessica Swain. preventionstrategist-digital.com/apiq/0124_spri…

Incredible work by Dartmouth Health Children's team led by Drs. Samantha (Sam) House and JoAnna Leyenaar on “Human-Centered Design to Improve Care for Youths Experiencing Psychiatric Boarding.” publications.aap.org/hospitalpediat… Dartmouth Health

“Routine weekly post-admission asymptomatic testing in a rehabilitation facility offered marginal gain beyond syndromic and targeted unit testing and was not associated with a reduced risk of healthcare-associated COVID-19.” cambridge.org/core/journals/…

For patients deemed unlikely to have a bacterial infection by #stewie team, 45% of teams stopped antibiotics within 48 hours of the recommendation. 3.8x higher number of adverse drug events when team continued antibiotics despite recommendation to stop. cambridge.org/core/journals/…

VA Portland Health Care System moved away from U/A with reflex urine culture. 33% ⬇️ in urine cultures, ⬆️ in urine culture positivity (36% -> 46%), ⬇️ in CAUTI rate per 1,000 catheter days (1.38 -> 0.56, NS). 38% of orders post-intervention were U/A only. cambridge.org/core/journals/…

Yikes. 50% of patients prematurely discontinued 4-month regimen of daily isoniazid, rifapentine, moxifloxacin, and pyrazinamide for pulmonary TB due to adverse events such as vomiting, elevated transaminases, and rash. academic.oup.com/ofid/advance-a…