Abstract. In outpatient parenteral antimicrobial therapy, weekly lab monitoring is often standard practice, even for antimicrobials with low complication r

Among patients with a hospital-acquired or health-care-associated Gram-negative bloodstream infection, cefiderocol resulted in non-inferior 14-day mortality compared with standard of care. Adverse eve...

Lessons learned from a diagnostic stewardship intervention in response to a blood culture bottle supply shock - Volume 5 Issue 1

Contrary to popular belief, peer review has only recently become an...

Hemophagocytic lymphohistiocytosis occurred in 20% of people with disseminated histoplasmosis at our institution in Arkansas. Very elevated serum ferritin,

Unraveling indications for discharge antibiotics: the Devil’s in the details - Volume 5 Issue 1

In this second-ever collaboration between SIDP’s Breakpoints and...

A nationwide shortage of blood culture bottles led to significant restriction of blood culture utilization at our institution.MethodsWe evaluated the impact of 3 combined interventions: (1) guidance on appropriate blood culture utilization, (2) restriction of repeat cultures within a 48-hour period, and (3) restriction of initial assessment to a single blood culture set consisting of 1 aerobic and 1 anaerobic blood culture bottle, on the management of patients with Staphylococcus aureus bacteremia (SAB) using an interrupted time series analysis.ResultsPrior to the intervention, 90.1% of patients had 2 blood culture sets ordered for initial assessment, versus 5.7% during the intervention and 84.1% postintervention. The median number of cultures to document SAB clearance was 4 (range, 2–17) in the preintervention period, 2 (range, 2–9) during the intervention period, and 4 (range, 3–11) postintervention. The median number of days to SAB clearance was not significantly different across the study periods, nor were days to central venous catheter placement or days of intravenous S aureus therapy. Fewer patients had documented SAB clearance within 24 hours and median time to diagnosis for community-acquired cases was longer in the intervention period, suggesting the restrictions were not without potential clinical impact.ConclusionsThese data demonstrate that efforts to reduce blood culture utilization should be implemented with careful stewardship in order to minimize adverse effects for patients with SAB.

The Athens Plague (430–427 BCE) was a devastating outbreak during the Peloponnesian War, described in detail by Thucydides. Although there is ongoing discussion, the specific cause of the epidemic rem...