Marisa Holubar
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View article: Systematic literature review and meta-analysis of urinary tract infections and sexually transmitted infections in symptomatic women: prevalence, patterns and clinical implications
Systematic literature review and meta-analysis of urinary tract infections and sexually transmitted infections in symptomatic women: prevalence, patterns and clinical implications Open
We performed a systematic literature review and meta-analysis of studies on urinary tract infections (UTIs) and sexually transmitted infections (STIs) in symptomatic women to evaluate prevalence, patterns and clinical implications. We sear…
View article: P-87. Real-world Efficacy and Outcomes Implementing Oral Antibiotics for Treatment of Bone and Joint Infections
P-87. Real-world Efficacy and Outcomes Implementing Oral Antibiotics for Treatment of Bone and Joint Infections Open
Background Traditionally, bone and joint infections have been treated with several weeks of intravenous (IV) antibiotic therapy; however clinical trial data support the safety and efficacy of oral antibiotics. Despite this, many physicians…
View article: P-1474. Antimicrobial Therapy of <i>Enterococcus faecium</i> Bacteremia: A Retrospective Comparison of Outcomes with IV or Oral Antimicrobial Therapy
P-1474. Antimicrobial Therapy of <i>Enterococcus faecium</i> Bacteremia: A Retrospective Comparison of Outcomes with IV or Oral Antimicrobial Therapy Open
Background Enterococci are one of the most common causes of hospital-associated infections. Enterococcus faecium has particularly been associated with prolonged hospitalizations, frequent comorbid conditions, and high rates of mortality. M…
View article: P-1642. The Devil's in the details: Developing metrics for discharge antibiotic stewardship
P-1642. The Devil's in the details: Developing metrics for discharge antibiotic stewardship Open
Background International Classification of Diseases, Tenth Revision codes (ICD-10s) are commonly used to identify antibiotic indications but may not reflect clinician intent. We investigated concordance of different antibiotic indication s…
View article: P-1643. Simply Scripting Success: Impact of Epic Preference List Changes on Antibiotic Prescribing in the Outpatient Setting
P-1643. Simply Scripting Success: Impact of Epic Preference List Changes on Antibiotic Prescribing in the Outpatient Setting Open
Background Preference lists in electronic health records are commonly used to streamline ordering processes, including antibiotic orders. In July 2023, we revised our institution's primary care preference list to align with institutional g…
View article: P-1709. Factors Associated with Anti-Methicillin-Resistant <i>Staphylococcus aureus</i> and Anti-<i>Pseudomonas aeruginosa</i> Therapy in Critically Ill Patients with Community-Acquired Pneumonia: A Single-Center Experience
P-1709. Factors Associated with Anti-Methicillin-Resistant <i>Staphylococcus aureus</i> and Anti-<i>Pseudomonas aeruginosa</i> Therapy in Critically Ill Patients with Community-Acquired Pneumonia: A Single-Center Experience Open
Background Current American Thoracic Society and Infectious Diseases Society of America community-acquired pneumonia (CAP) guidelines recommend empiric antibiotic therapy against methicillin-resistant Staphylococcus aureus (MRSA) or Pseudo…
View article: Weighing options: empiric antibiotic use and stewardship opportunities in critically ill patients with community-acquired pneumonia
Weighing options: empiric antibiotic use and stewardship opportunities in critically ill patients with community-acquired pneumonia Open
In this retrospective study, critically ill patients with community-acquired pneumonia frequently received empiric anti-methicillin-resistant Staphylococcus aureus (MRSA) and antipseudomonal antibiotics despite having few or no guidelines-…
View article: Beyond the basics: rethinking antimicrobial stewardship by targeting cytomegalovirus immune globulin for immunocompromised patients
Beyond the basics: rethinking antimicrobial stewardship by targeting cytomegalovirus immune globulin for immunocompromised patients Open
Identifying actionable stewardship targets in immunocompromised patients is challenging due to limited data and high morbidity. One approach could be targeting therapy with limited evidence, like cytomegalovirus immune globulin (CMV-IGIV).…
View article: Macro- and micro-influencers of antimicrobial costs…What do stewardship programs need to know?
Macro- and micro-influencers of antimicrobial costs…What do stewardship programs need to know? Open
The high cost of antimicrobials presents critical challenges for healthcare providers managing infections amidst the growing threat of antimicrobial resistance (AMR). High costs hinder access to necessary treatments, disproportionately aff…
View article: How to leverage medication use evaluations for antimicrobial stewardship goals: a primer for physicians
How to leverage medication use evaluations for antimicrobial stewardship goals: a primer for physicians Open
Medication Use Evaluations (MUEs) are structured quality improvement tools used to optimize medication use within healthcare systems. MUEs can explore safety concerns, high costs, or inappropriate use associated with any medication, among …
View article: Unraveling indications for discharge antibiotics: the Devil’s in the details
Unraveling indications for discharge antibiotics: the Devil’s in the details Open
Objective: Discharge is a pivotal transition of care moment; however, discharge antibiotic stewardship efforts have historically been limited. Our institution has a mandatory indication field for inpatient antibiotic orders. Using the last…
View article: No “One-Size-Fits All”: chronic “Carryover” diagnoses dilute antibiotic prescribing rates for sinusitis among adults in primary and urgent care settings
No “One-Size-Fits All”: chronic “Carryover” diagnoses dilute antibiotic prescribing rates for sinusitis among adults in primary and urgent care settings Open
International Classification of Diseases, Tenth Revision (ICD-10) billing data used in outpatient stewardship metrics is under-described for acute and chronic sinusitis. We found that different sinusitis ICD-10 definitions impacted antibio…
View article: Implementing Oral Antibiotics for Bone and Joint Infections: Lessons Learned and Opportunities for Improvement
Implementing Oral Antibiotics for Bone and Joint Infections: Lessons Learned and Opportunities for Improvement Open
Background Although intravenous antibiotics have historically been the standard of care for bone and joint infections, clinical trial data have highlighted the safety and efficacy of oral antibiotics. Despite this, intravenous antibiotics …
View article: Sex differences and immune correlates of Long Covid development, symptom persistence, and resolution
Sex differences and immune correlates of Long Covid development, symptom persistence, and resolution Open
Sex differences have been observed in acute coronavirus disease 2019 (COVID-19) and Long Covid (LC) outcomes, with greater disease severity and mortality during acute infection in males and greater proportions of females developing LC. We …
View article: Implementing the Infectious Diseases Society of America Antimicrobial Stewardship Core Curriculum: Survey Results and Real-World Strategies to Guide Fellowship Programs
Implementing the Infectious Diseases Society of America Antimicrobial Stewardship Core Curriculum: Survey Results and Real-World Strategies to Guide Fellowship Programs Open
Background The Infectious Diseases Society of America (IDSA) developed the Core Antimicrobial Stewardship (AS) Curriculum to meet the increasing demand for infectious diseases (ID) providers with AS expertise. Notable diversity in implemen…
View article: Diagnostic stewardship and dermatology consultation in cellulitis management: a systematic literature review and meta-analysis
Diagnostic stewardship and dermatology consultation in cellulitis management: a systematic literature review and meta-analysis Open
Importance: Cellulitis is a common skin infection often requiring antibiotic treatment. However, misdiagnosis and inappropriate antibiotic use contribute to antibiotic resistance and healthcare costs. Objective: We aimed to evaluate the im…
View article: Sex differences and immune correlates of Long COVID development, persistence, and resolution
Sex differences and immune correlates of Long COVID development, persistence, and resolution Open
Sex differences have been observed in acute COVID-19 and Long COVID (LC) outcomes, with greater disease severity and mortality during acute infection in males and a greater proportion of females developing LC. We hypothesized that sex-spec…
View article: Syphilis Treatment: Systematic Review and Meta-Analysis Investigating Nonpenicillin Therapeutic Strategies
Syphilis Treatment: Systematic Review and Meta-Analysis Investigating Nonpenicillin Therapeutic Strategies Open
Background Penicillin's long-standing role as the reference standard in syphilis treatment has led to global reliance. However, this dependence presents challenges, prompting the need for alternative strategies. We performed a systematic l…
View article: “Electronic Phenotyping” Antimicrobials to Facilitate Outpatient Stewardship for Asymptomatic Bacteriuria and Urinary Tract Infection in Renal Transplant
“Electronic Phenotyping” Antimicrobials to Facilitate Outpatient Stewardship for Asymptomatic Bacteriuria and Urinary Tract Infection in Renal Transplant Open
Asymptomatic bacteriuria and urinary tract infection in renal transplant are important antimicrobial stewardship targets but are difficult to identify within electronic medical records. We validated an “electronic phenotype” of antibacteri…
View article: Combination Antifungal Therapy for Invasive Mucormycosis in Immunocompromised Hosts: A Single-Center Experience
Combination Antifungal Therapy for Invasive Mucormycosis in Immunocompromised Hosts: A Single-Center Experience Open
Combination antifungal therapy for invasive mucormycosis remains controversial and is inconsistently defined in prior studies. In a cohort of patients with immunocompromised status and invasive mucormycosis, we found no difference in 6-wee…
View article: “Keeping us on our toes”: a review of what clinicians need to know about vancomycin-variable <i>Enterococcus</i>
“Keeping us on our toes”: a review of what clinicians need to know about vancomycin-variable <i>Enterococcus</i> Open
Enterococcus faecium is a difficult-to-treat gram positive organism with increasing rates of resistance to vancomycin which is commonly mediated through the vanA gene cluster. There have been international reports of E. faecium isolates th…
View article: Evaluation of interventions led by pharmacists in antimicrobial stewardship programs in low- and middle-income countries: a systematic literature review
Evaluation of interventions led by pharmacists in antimicrobial stewardship programs in low- and middle-income countries: a systematic literature review Open
Objective: We performed a systematic literature review to identify and describe pharmacist-led antimicrobial stewardship programs (ASPs) interventions in low- and middle-income countries (LMICs). Design: Systematic literature review. Metho…
View article: Clinical decision support in the electronic health record: a primer for antimicrobial stewards and infection preventionists: work smarter so end users don’t work harder
Clinical decision support in the electronic health record: a primer for antimicrobial stewards and infection preventionists: work smarter so end users don’t work harder Open
Objective: Computerized clinical decision support (CDS) assists healthcare professionals in making decisions to improve patient care. In the realms of antimicrobial stewardship (ASP) and infection prevention (IP) programs, CDS intervention…
View article: 2275. No "One-Size-Fits All": Chronic "Carryover" Diagnoses Dilute Antibiotic Prescribing Metrics in Primary Care
2275. No "One-Size-Fits All": Chronic "Carryover" Diagnoses Dilute Antibiotic Prescribing Metrics in Primary Care Open
Background International Classification of Diseases, Tenth Revision (ICD-10) encounter coding is used to identify sub-optimal outpatient antibiotic use, but the utility of a popular billing data based metric, antibiotic prescribing rate (A…
View article: 2741. Hit Me with Your Best Shot: Improving Pre-Lung Transplant Vaccination Rates with Infectious Disease Evaluation
2741. Hit Me with Your Best Shot: Improving Pre-Lung Transplant Vaccination Rates with Infectious Disease Evaluation Open
Background Vaccine preventable diseases and reactivation of latent infections occur commonly post-solid organ transplant and can result in severe infections. Vaccination and screening for latent infections in the pre-transplant period are …
View article: 824. Combination Antifungal Therapy for Invasive Mucormycosis in Immunocompromised Hosts: A Single-Center Experience
824. Combination Antifungal Therapy for Invasive Mucormycosis in Immunocompromised Hosts: A Single-Center Experience Open
Background Invasive mucormycosis continues to be associated with high rates of mortality despite advances in management strategies. Recent studies have suggested a benefit to early combination therapy, but overall, the data remain limited …
View article: 765. Development of an Adaptable Roadmap for Implementation of the Infectious Diseases Society of America Core Antimicrobial Stewardship Curriculum in Infectious Diseases Fellowship Programs
765. Development of an Adaptable Roadmap for Implementation of the Infectious Diseases Society of America Core Antimicrobial Stewardship Curriculum in Infectious Diseases Fellowship Programs Open
Background The Infectious Diseases Society of America (IDSA) developed and disseminated a Core Antimicrobial Stewardship (AS) Curriculum intended to formalize AS training in infectious diseases (ID) fellowship programs in 2018. This study …
View article: Electronic phenotyping of community-acquired pneumonia: A tool for inpatient syndrome-specific antimicrobial stewardship
Electronic phenotyping of community-acquired pneumonia: A tool for inpatient syndrome-specific antimicrobial stewardship Open
Background: Using patient data from the electronic health record (EHR) and computer logic, an “electronic phenotype” can be created to identify patients with community-acquired pneumonia (CAP) in real time to assist with syndrome-specific …
View article: “Acute urinary antibiotics”—A simple metric to identify outpatient antibiotic stewardship opportunities in renal transplant
“Acute urinary antibiotics”—A simple metric to identify outpatient antibiotic stewardship opportunities in renal transplant Open
Background: International Classification of Diseases, Tenth Edition (ICD-10) data help track outpatient antibiotic prescribing but lack validation in immunocompromised populations or subspecialty clinics for this purpose. Asymptomatic bact…
View article: A quality-improvement approach to urgent-care antibiotic stewardship for respiratory tract infections during the COVID-19 pandemic: Lessons learned
A quality-improvement approach to urgent-care antibiotic stewardship for respiratory tract infections during the COVID-19 pandemic: Lessons learned Open
Objective: We investigated a decrease in antibiotic prescribing for respiratory illnesses in 2 academic urgent-care clinics during the coronavirus disease 2019 (COVID-19) pandemic using semistructured clinician interviews. Methods: We cond…