Among hospitalized adults who received vancomycin for their skin and skin structure infection (SSSI), patients who experienced acute kidney injury (AKI) had considerably higher 30-day readmission rates. Nearly half of the observed 30-day readmissions were due to non-SSSI-related reasons, consistent with the persistent organ dysfunction observed among patients with AKI.

Study Objectives: This study sought to compare real-world effectiveness outcomes between hospitalized patients with Clostridioides difficile infections (CDIs) who received early-targeted fidaxomicin or oral vancomycin at two Veterans Affairs Medical Centers (VAMCs).

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We report the complete genome sequence of a clinical isolate of Providencia stuartii strain CMC-4104, isolated from a splenic abscess. Oxford Nanopore Technologies (ONT) and Illumina sequencing reads were assembled using Geneious to generate a 4,504,925-bp circular chromosome containing multiple copies of the NDM-1 and PER-1 genes in a genomic resistance island.

IntroductionPatients are often discharged from the emergency department (ED) prior to final culture results, leading to the development of post‐ED discharge urine culture review programs (UCRPs) to ensure appropriate management. The purpose of this study was to evaluate the impact ED pharmacists have on antibiotic management and determine areas for improved antimicrobial stewardship efforts.MethodsThis was a single‐system, retrospective, quasi‐experimental study of patients who visited the ED for evaluation of a urinary tract infection comparing no pharmacist involvement in a culture review to a process when ED pharmacists were involved. Patients included those discharged from the ED requiring review under a UCRP. Incarcerated patients and those admitted to an inpatient service from the ED were excluded. The primary outcome was the receipt of guideline‐appropriate management. Secondary outcomes included unplanned admission or ED revisit within 14 and 30 days related to the initial ED visit, all‐cause hospital admission or ED revisit within 14 and 30 days, and acceptance rate of pharmacist recommendations.ResultsA total of 142 patients were included (before pharmacist integration = 70, after pharmacist integration = 72). Receipt of guideline‐appropriate management occurred at 33% without pharmacist integration and 85% in the arm with pharmacist integration, p < 0.001. Pharmacist recommendations were accepted in 97% of cases. No difference was noted between ED revisit within 14 and 30 days with a chief complaint directly related to the initial ED visit, 14 and 30 day admission related to the initial encounter, and all‐cause hospital admission or ED revisit within 14 and 30 days. In patients with asymptomatic bacteriuria, there was a higher receipt of inappropriate management 67% (20/30) in the time before pharmacist integration versus 19% (9/48) after pharmacist integration (p < 0.001).ConclusionThere was a significantly higher number of patients with appropriate antimicrobial management after pharmacist involvement in UCRP review.