Annals for Hospitalists Inpatient Notes - Mindfulness and Antibiotic Appropriateness—How Point-of-Care Stewardship Begins With Hospitalists
Authors: Valerie M. Vaughn, Scott A. Flanders
Journal: Annals of Internal Medicine (2016)

Web Exclusives15 November 2016Annals for Hospitalists Inpatient Notes - Mindfulness and Antibiotic Appropriateness—How Point-of-Care Stewardship Begins With HospitalistsValerie M. Vaughn, MD and Scott A. Flanders, MDValerie M. Vaughn, MDFrom University of Michigan, Ann Arbor, Michigan.Search for more papers by this author and Scott A. Flanders, MDFrom University of Michigan, Ann Arbor, Michigan.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M16-2043 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Antibiotics are critical, lifesaving drugs for many patients, and so it is not surprising that more than half of hospitalized patients receive them. What is surprising is that up to half of those antibiotics may be unnecessary (1). Widespread overuse has contributed to a rise in antimicrobial resistance, Clostridium difficile infection, and adverse drug reactions. As hospitalists, we share the responsibility for tackling this difficult issue.Inappropriate antibiotic use has 2 key drivers. First, antibiotics are often prescribed in ways that differ from evidence-based guidelines. Empirical antibiotics are often too broad, not targeted to culture results, or prescribed for too ...References1. Fridkin S, Baggs J, Fagan R, Magill S, Pollack L, Malpiedi P, et al. Vital signs: improving antibiotic use among hospitalized patients. MMWR Morb Mortal Wkly Rep. 2014;63:194-200. MedlineGoogle Scholar2. Balogh EP, Miller BT, Ball JR, eds. Improving Diagnosis in Health Care. Washington, DC: National Academies Pr; 2015. Google Scholar3. Filice GA, Drekonja DM, Thurn JR, Hamann GM, Masoud BT, Johnson JR. Diagnostic errors that lead to inappropriate antimicrobial use. Infect Control Hosp Epidemiol. 2015;36:949-56. [PMID: 25998898] doi:10.1017/ice.2015.113 CrossrefMedlineGoogle Scholar4. Jones GR, Lowes JA. The systemic inflammatory response syndrome as a predictor of bacteraemia and outcome from sepsis. QJM. 1996;89:515-22. [PMID: 8759492] CrossrefMedlineGoogle Scholar5. Kiyatkin D, Bessman E, McKenzie R. Impact of antibiotic choices made in the emergency department on appropriateness of antibiotic treatment of urinary tract infections in hospitalized patients. J Hosp Med. 2016;11:181-4. [PMID: 26559929] doi:10.1002/jhm.2508 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From University of Michigan, Ann Arbor, Michigan.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M16-2043.Corresponding Author: Valerie M. Vaughn, MD, University of Michigan, Division of General Medicine, Department of Internal Medicine, 2800 Plymouth Road, Building 16, Room 430W, Ann Arbor, MI 48109; e-mail, [email protected]umich.edu.Current Author Addresses: Drs. Vaughn and Flanders: University of Michigan, Division of General Medicine, Department of Internal Medicine, 2800 Plymouth Road, Building 16, Room 430W, Ann Arbor, MI 48109. Previousarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoAnnals for Hospitalists - 15 November 2016 David H. Wesorick and Vineet Chopra Metrics Cited byAntibiotic stewardship teams and Clostridioides difficile practices in United States hospitals: A national survey in The Joint Commission antibiotic stewardship standard eraExcess Antibiotic Treatment Duration and Adverse Events in Patients Hospitalized With Pneumonia A Multihospital Cohort StudyValerie M. Vaughn, MD, MSc, Scott A. Flanders, MD, Ashley Snyder, MS, Anna Conlon, PhD, Mary A.M. Rogers, PhD, MS, Anurag N. Malani, MD, Elizabeth McLaughlin, MS, RN, Sarah Bloemers, MPH, Arjun Srinivasan, MD, Jerod Nagel, PharmD, BCPS, Scott Kaatz, DO, Danielle Osterholzer, MD, Rama Thyagarajan, MD, Lama Hsaiky, PharmD, BCPS, Vineet Chopra, MD, MSc, and Tejal N. Gandhi, MDPrevious mindfulness experience interacts with brief mindfulness induction when reducing stimulus overselectivityBrief Mindfulness Practices for Healthcare Providers – A Systematic Literature ReviewAnnals for Hospitalists: Celebrating the One-Year Anniversary of an Easier Way for Hospitalists to Access AnnalsDavid H. Wesorick, MD and Vineet Chopra, MD, MSc 15 November 2016Volume 165, Issue 10Page: HO2-HO3KeywordsAntibioticsBloodDiagnostic medicineDisclosureEmergency departmentFeversHospitalistsInpatientsSystemic inflammatory response syndromeUrine ePublished: 15 November 2016 Issue Published: 15 November 2016 Copyright & PermissionsCopyright © 2016 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...