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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (1)
- (-) Antibiotics (5)
- Antimicrobial Stewardship (1)
- Cancer (1)
- Children/Adolescents (1)
- Critical Care (1)
- Dental and Oral Health (1)
- Guidelines (1)
- Healthcare-Associated Infections (HAIs) (1)
- Intensive Care Unit (ICU) (1)
- Medication (4)
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- Newborns/Infants (1)
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- Sepsis (1)
- Surgery (1)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 5 of 5 Research Studies DisplayedDe Castro GC, Slatnick LR, Shannon M
Impact of time-to-antibiotic delivery in pediatric patients with cancer presenting with febrile neutropenia.
Researchers abstracted episodes of febrile neutropenia (FN) in pediatric patients with cancer occurring at Vanderbilt Children's Hospital and Colorado Children's Hospital to capture time-to-antibiotic (TTA) metrics and clinical outcomes including major complications. Results showed that only 0.6% of episodes required immediate ICU management, with a median TTA of 28 minutes; for the remaining patients, the median TTA was 56 minutes. TTA was not associated with major nor any other complications in adjusted analysis. The researchers concluded that there was no clear evidence that a reduced TTA improves clinical outcomes in pediatric oncology FN and it should not be used as a primary quality measure.
AHRQ-funded; HS025696.
Citation: De Castro GC, Slatnick LR, Shannon M .
Impact of time-to-antibiotic delivery in pediatric patients with cancer presenting with febrile neutropenia.
JCO Oncol Pract 2024 Feb; 20(2):228-38. doi: 10.1200/op.23.00583..
Keywords: Children/Adolescents, Cancer, Antibiotics, Medication
Ramanathan S, Evans CT, Hershow RC
Guideline concordance and antibiotic-associated adverse events between Veterans administration and non-Veterans administration dental settings: a retrospective cohort study.
The study aimed to evaluate antibiotic prophylaxis adherence and associated adverse drug events (ADEs) in dental settings. A retrospective cohort study of adults with cardiac conditions or prosthetic joints from 2015 to 2017 was conducted. Of 61,124 patients receiving antibiotic prophylaxis, 62 (0.1%) experienced ADEs. Guideline concordance was not linked to ADEs (adjusted OR: 0.78, 95% CI: 0.25-2.46), and this was consistent across different dental settings.
AHRQ-funded; HS025177.
Citation: Ramanathan S, Evans CT, Hershow RC .
Guideline concordance and antibiotic-associated adverse events between Veterans administration and non-Veterans administration dental settings: a retrospective cohort study.
Front Pharmacol 2024 Jan 16; 15:1249531. doi: 10.3389/fphar.2024.1249531.
Keywords: Antibiotics, Medication, Adverse Drug Events (ADE), Guidelines, Dental and Oral Health, Practice Patterns
Qureshi N, Kroger J, Zangwill KM
Changes in perceptions of antibiotic stewardship among neonatal intensive care unit providers over the course of a learning collaborative: a prospective, multisite, mixed-methods evaluation.
The purpose of this study was to assess clinician perceptions towards the value and implementation of antibiotic stewardship (AS) in neonatal intensive care units (NICU). The researchers conducted a mixed-methods study of AS perceptions utilizing surveys and interviews in 30 California NICUs before and after a multicenter collaborative (Optimizing Antibiotic Use in California NICUs [OASCN]). The study found that pre-OASCN, 24% of respondents believed there was "a lot of" or "some" inappropriate prescribing, often driven by fear of a bad outcome or hesitation to change existing practices. Clinicians reported statistically significant increases in AS importance, perceived AS activity, and more openness to change after OASCN.
AHRQ-funded; HS026168.
Citation: Qureshi N, Kroger J, Zangwill KM .
Changes in perceptions of antibiotic stewardship among neonatal intensive care unit providers over the course of a learning collaborative: a prospective, multisite, mixed-methods evaluation.
J Perinatol 2024 Jan; 44(1):62-70. doi: 10.1038/s41372-023-01823-0..
Keywords: Antibiotics, Antimicrobial Stewardship, Newborns/Infants, Intensive Care Unit (ICU), Critical Care
Donnelly JP, Seelye SM, Kipnis P
Impact of reducing time-to-antibiotics on sepsis mortality, antibiotic use, and adverse events.
Researchers estimated benefits and harms of shortened time-to-antibiotics for sepsis. Their simulation study used a cohort of over 1.5 million hospitalizations via emergency department with more than two systemic inflammatory response syndrome criteria. The results showed that impacts of faster time-to-antibiotics for sepsis varied markedly across simulated hospital types; however, even in worst-case scenarios, new antibiotic-associated adverse events were rare.
AHRQ-funded; HS026725.
Citation: Donnelly JP, Seelye SM, Kipnis P .
Impact of reducing time-to-antibiotics on sepsis mortality, antibiotic use, and adverse events.
Ann Am Thorac Soc 2024 Jan; 21(1):94-101. doi: 10.1513/AnnalsATS.202306-505OC..
Keywords: Antibiotics, Medication, Sepsis, Mortality
Liu S, Matvekas A, Naimi T
Morphomics-informed population pharmacokinetic and physiologically-based pharmacokinetic modeling to optimize cefazolin surgical prophylaxis.
This study’s objective was to use algorithms that repurpose radiologic data into body composition (morphomics) to aid in informing dosing decisions for the antibiotic cefazolin for patients undergoing colorectal surgery who have obesity. This prospective study measured cefazolin plasma, fat, and colon tissue concentrations in these patients to develop a morphomics-informed population pharmacokinetic (PopPK) model to guide dose adjustments. A physiologically-based pharmacokinetic (PBPK) model was also constructed to inform tissue partitioning in 21 morbidly obese patients (body mass index ≥35 kg/m2 with one or more co-morbid conditions). Morphomics and pharmacokinetic data were available in 58 patients with a median weight of 95.9 kg and and 55 years, respectively. The plasma-to-subcutaneous fat partition coefficient was predicted to be 0.072 for the PopPK model and 0.060 for the PBPK model. Covariates of cefazolin exposure were identified as the estimated creatinine clearance (eCL(cr) ) and body depth at the third lumbar vertebra (body depth_L3). The authors concluded that kidney function and morphomics were more informative than body weight as covariates of cefazolin target site exposure. They advised that data from more diverse populations, consensus on target cefazolin exposure, and comparative studies are needed before a change in practice can be implemented.
AHRQ-funded; HS027183.
Citation: Liu S, Matvekas A, Naimi T .
Morphomics-informed population pharmacokinetic and physiologically-based pharmacokinetic modeling to optimize cefazolin surgical prophylaxis.
Pharmacotherapy 2024 Jan; 44(1):77-86. doi: 10.1002/phar.2878..
Keywords: Surgery, Antibiotics, Medication, Prevention, Obesity, Healthcare-Associated Infections (HAIs)