Jared Olson

A survey of the utilization of anti-pseudomonal beta-lactam therapy in cystic fibrosis patients.

The purpose of this study was to characterize the utilization of anti‐pseudomonal beta‐lactam antibiotics in the treatment of acute pulmonary exacerbations (APE) among Cystic Fibrosis Foundation (CFF)‐accredited care centers. An anonymous national cross‐sectional survey of CFF‐accredited care centers was performed using an electronic survey tool (SurveyMonkey.com®). One hundred and twenty‐one of 261 centers completed the survey (46%) representing 56% (14,856/26,740) of patients in the CFF Patient Registry. One hundred and nineteen of 121 (98%) respondents reported using beta‐lactams for the treatment of APE. Intermittent dosing regimens constituted 155/167 (93%) reported regimens, while extended infusions were 12/167 (7%). Ceftazidime was the most commonly utilized beta‐lactam comprising 74/167 (44%) of all infusions (intermittent and extended) of which 70/74 (95%) were intermittent infusions. The majority of intermittent ceftazidime regimens (56/70; 80%) were at doses lower than CFF and European guidelines recommended doses. In conclusion, a great majority of respondents use intermittent anti‐pseudomonal beta‐lactam antibiotics, with over half of respondents utilizing lower than guidelines recommended doses. While this is of concern, it is not known if optimization of dosing strategies according to guidelines recommendations will result in clinical benefit. Pediatr. Pulmonol. 2011; 46:987–990.

Utilization of antibiotics for methicillin-resistant Staphylococcus aureus infection in cystic fibrosis.

The purpose of this study was to characterize the utilization of antibiotics for chronic methicillin‐resistant Staphylococcus aureus (MRSA) infection in cystic fibrosis (CF) patients with acute pulmonary exacerbations (PEx).

Response-based therapy for ruptured appendicitis reduces resource utilization

PURPOSE We examined the effectiveness of a postoperative ruptured appendicitis protocol that eliminated Pseudomonas coverage and based the duration of IV antibiotic treatment and length of hospital stay on the patients clinical response. METHODS In our new protocol, IV antibiotics were administered until the patient met discharge criteria: adequate oral intake, pain control with oral medications, and afebrile for 24h. We collected data on all patients with ruptured appendicitis at our institution following protocol implementation (May 1, 2012, to April 30, 2013) and compared them to a control group. RESULTS 306 patients were treated (154 prior protocol, 152 new protocol). The new clinical response-based protocol led to a decrease in hospital stay from 134h (SD 66.1) to 94.5h (SD 61.7) (p<0.001) and total cost of care per patient also decreased from

A dynamic postoperative protocol provides efficient care for pediatric patients with non-ruptured appendicitis.

13,610 (SD

Determination of Optimal Amikacin Dosing Regimens for Pediatric Patients With Burn Wound Sepsis.

6859) to

Epidemiology of Methicillin-Resistant Staphylococcus aureus Bacteremia in Children

9870 (SD

Pharmacodynamic studies of voriconazole: informing the clinical management of invasive fungal infections

5670) (p<0.001). CONCLUSION Our clinical response-based protocol for pediatric patients with ruptured appendicitis decreased LOS, cost, and IV antibiotics use without significant changes in adverse events.

Impact of Antimicrobial Stewardship for Pediatric Outpatient Parenteral Antibiotic Therapy

PURPOSE Postoperative management of pediatric patients with non-ruptured appendicitis is highly variable and often includes an overnight stay in the hospital. We implemented a criteria-based postoperative protocol designed to eliminate postoperative antibiotics and facilitate timely discharge by utilizing the bedside nurse to evaluate for readiness for discharge. METHODS We collected data on all patients with non-ruptured appendicitis at our institution following protocol implementation (May 1, 2012 to April 30, 2013) and compared them to a control group. RESULTS 580 patients were treated for non-ruptured appendicitis (285 prior protocol, 295 new protocol). Following implementation of our protocol, there was an overall reduction in length of stay from 40.1 (SD 27.5) to 23.5 (SD 20.8)h, and total cost of care per patient also decreased from

Infectious Etiologies and Patient Outcomes in Pediatric Septic Shock.

5783 (SD

Outpatient Parenteral Antimicrobial Therapy in Young Infants

2501) to