Persons living with HIV (PLWH) are at an increased risk of contraindicated drug-drug interactions (XDDIs), which may result in deleterious outcomes. Study objectives were to (1) compare the frequency of hospitalizations between patients with and without XDDIs and (2) determine if XDDIs are independently associated with hospitalizations in PLWH. A retrospective cohort study was performed among PLWH receiving care at the

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.

Background Diabetic foot infections (DFIs) are commonly associated with antibiotic overuse. Empiric DFI treatment often includes coverage for Pseudomonas aeruginosa (PsA), but the frequency of PsA DFIs is poorly understood. The study objectives were to quantify the prevalence of and determine predictors for PsA DFIs. Methods Multicenter, retrospective cohort of hospitalized patients with DFI from 2013-2020. Inclusion criteria: age ≥18 years, diabetes mellitus diagnosis and DFI based on ICD-10 coding, antibiotic treatment, DFI culture with organism growth. Osteomyelitis was excluded. Patient characteristics were described and compared; the primary outcome was presence of PsA on DFI-culture. Predictors of PsA DFI were identified using multivariable logistic regression. Results 292 patients were included from five centers. The median (IQR) age of the population was 61 (53-69) years; the majority of patients were men (201, 69%) and Caucasian (163, 56%). Two-hundred forty-two (83%) patients took outpatient anti-diabetic medications and the median (IQR) percent pre-hospitalization hemoglobin A1C was 8.3 (6.9-9.9). The most commonly isolated organisms were methicillin-susceptible Staphylococcus aureus (35%) and streptococci (32%); 147 (54%) of cultures were polymicrobial. Two-hundred fifty-seven (88%) patients received empiric antibiotics active against PsA, but only 27 (9%) patients had PsA DFI. Immunocompromised status (adjOR, 4.6; 95%CI, 1.3-16.7) and outpatient DFI antibiotic treatment failure in preceding 90-days (adjOR, 4.8; 95%CI, 1.9-11.9) were associated with PsA DFI. Conclusions PsA DFI is uncommon, but most patients receive empiric anti-pseudomonal antibiotics. Empiric broad spectrum antibiotics are warranted given the frequency of mixed infections, but patient-specific risk factors should be considered before adding anti-pseudomonal coverage.