Scholars@Duke
Elizabeth Dodds Ashley

Elizabeth Dodds Ashley

Professor in Medicine
Medicine, Infectious Diseases
libby.dodds@duke.edu
Duke Box 102359, Durham, NC 27710
315 Trent Drive, Hanes House, Room 170, Durham, NC 27710

Selected Publications

Long-term trends in the incidence of hospital-acquired carbapenem-resistant Enterobacterales and antimicrobial utilization in a network of community hospitals in the Southeastern United States from 2013 to 2023.

Journal Article Infection control and hospital epidemiology · December 2024 BackgroundCarbapenem-resistant Enterobacterales (CRE) are an urgent threat to healthcare, but the epidemiology of these antimicrobial-resistant organisms may be evolving in some settings since the COVID-19 pandemic. An updated analysis of h ... Full text Cite

Five steps to high quality antimicrobial stewardship research.

Journal Article Antimicrob Steward Healthc Epidemiol · 2024 The escalating threat of antimicrobial resistance (AMR) necessitates impactful, reproducible, and scalable antimicrobial stewardship strategies. This review addresses the critical need to enhance the quality of antimicrobial stewardship intervention resear ... Full text Link to item Cite

Harvesting the low-hanging fruit? Comparative assessment of intravenous to oral route antimicrobial conversion policy implementation.

Journal Article Infect Control Hosp Epidemiol · June 2023 Policies that promote conversion of antibiotics from intravenous to oral route administration are considered "low hanging fruit" for hospital antimicrobial stewardship programs. We developed a simple metric based on digestive days of therapy divided by tot ... Full text Link to item Cite

The Disproportionate Impact of Coronavirus Disease 2019 (COVID-19) Pandemic on Healthcare-Associated Infections in Community Hospitals: Need for Expanding the Infectious Disease Workforce.

Journal Article Clin Infect Dis · February 8, 2023 BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic had a considerable impact on US healthcare systems, straining hospital resources, staff, and operations. However, a comprehensive assessment of the impact on healthcare-associated infections (HAI ... Full text Link to item Cite

Evaluation of an Opt-Out Protocol for Antibiotic De-Escalation in Patients With Suspected Sepsis: A Multicenter, Randomized, Controlled Trial.

Journal Article Clin Infect Dis · February 8, 2023 BACKGROUND: Sepsis guidelines recommend daily review to de-escalate or stop antibiotics in appropriate patients. This randomized, controlled trial evaluated an opt-out protocol to decrease unnecessary antibiotics in patients with suspected sepsis. METHODS: ... Full text Link to item Cite

The impact of coronavirus disease 2019 (COVID-19) response on hospital infection prevention programs and practices in the southeastern United States.

Journal Article Infect Control Hosp Epidemiol · February 2023 Initial assessments of coronavirus disease 2019 (COVID-19) preparedness revealed resource shortages and variations in infection prevention policies across US hospitals. Our follow-up survey revealed improvement in resource availability, increase in testing ... Full text Link to item Cite

Review of antibiotic prescriptions as part of antimicrobial stewardship programmes: results from a pilot implementation at two provincial-level hospitals in Viet Nam.

Journal Article JAC Antimicrob Resist · February 2023 OBJECTIVES: To investigate the feasibility of retrospective prescription-based review and to describe the antibiotic prescribing patterns to provide information for an antimicrobial stewardship programme in Viet Nam. METHODS: This study was conducted in tw ... Full text Link to item Cite

An Implementation Roadmap for Establishing Remote Infectious Disease Specialist Support for Consultation and Antibiotic Stewardship in Resource-Limited Settings.

Journal Article Open Forum Infect Dis · December 2022 Infectious Disease (ID)-trained specialists, defined as ID pharmacists and ID physicians, improve hospital care by providing consultations to patients with complicated infections and by leading programs that monitor and improve antibiotic prescribing. Howe ... Full text Link to item Cite

Identifying context-specific domains for assessing antimicrobial stewardship programmes in Asia: protocol for a scoping review.

Journal Article BMJ Open · September 15, 2022 INTRODUCTION: Antimicrobial stewardship (AMS) is an important strategy to control antimicrobial resistance. Resources are available to provide guidance for design and implementation of AMS programmes, however these may have limited applicability in resourc ... Full text Link to item Cite

The Impact of Centers for Medicare & Medicaid Services SEP-1 Core Measure Implementation on Antibacterial Utilization: A Retrospective Multicenter Longitudinal Cohort Study With Interrupted Time-Series Analysis.

Journal Article Clin Infect Dis · August 31, 2022 BACKGROUND: The impact of the US Centers for Medicare & Medicaid Services (CMS) Severe Sepsis and Septic Shock: Management Bundle (SEP-1) core measure on overall antibacterial utilization is unknown. METHODS: We performed a retrospective multicenter longit ... Full text Link to item Cite

Use of Contact Networks to Estimate Potential Pathogen Risk Exposure in Hospitals.

Journal Article JAMA Netw Open · August 1, 2022 IMPORTANCE: Person-to-person contact is important for the transmission of health care-associated pathogens. Quantifying these contact patterns is crucial for modeling disease transmission and understanding routes of potential transmission. OBJECTIVE: To ge ... Full text Link to item Cite

Top Myths of Diagnosis and Management of Infectious Diseases in Hospital Medicine.

Journal Article Am J Med · July 2022 Antimicrobial agents are among the most frequently prescribed medications during hospitalization. However, approximately 30% to 50% or more of inpatient antimicrobial use is unnecessary or suboptimal. Herein, we describe 10 common myths of diagnosis and ma ... Full text Link to item Cite

Thoughts and beliefs of healthcare workers regarding the coronavirus disease 2019 (COVID-19) vaccine and which messaging themes might affect vaccine confidence and recommendation of the vaccine.

Journal Article Antimicrob Steward Healthc Epidemiol · 2022 We surveyed healthcare workers within the Duke Antimicrobial Stewardship Outreach Network (DASON) to describe beliefs regarding coronavirus disease 2019 (COVID-19) vaccination and their decision-making process behind vaccination recommendations. In contras ... Full text Link to item Cite

Development of an Electronic Definition for De-escalation of Antibiotics in Hospitalized Patients.

Journal Article Clin Infect Dis · December 6, 2021 BACKGROUND: Antimicrobial stewardship programs (ASPs) promote the principle of de-escalation: moving from broad- to narrow-spectrum agents and stopping antibiotics when no longer indicated. A standard, objective definition of de-escalation applied to elect ... Full text Link to item Cite

Electronically Available Patient Claims Data Improve Models for Comparing Antibiotic Use Across Hospitals: Results From 576 US Facilities.

Journal Article Clin Infect Dis · December 6, 2021 BACKGROUND: The Centers for Disease Control and Prevention (CDC) uses standardized antimicrobial administration ratios (SAARs)-that is, observed-to-predicted ratios-to compare antibiotic use across facilities. CDC models adjust for facility characteristics ... Full text Link to item Cite

Reply to Day et al.

Journal Article J Infect Dis · November 16, 2021 Full text Link to item Cite

Effects of a Collaborative, Community Hospital Network for Antimicrobial Stewardship Program Implementation.

Journal Article Clin Infect Dis · November 2, 2021 BACKGROUND: Individual hospitals may lack expertise, data resources, and educational tools to support antimicrobial stewardship programs (ASP). METHODS: We established a collaborative, consultative network focused on hospital ASP implementation. Services i ... Full text Link to item Cite

Assessing feasibility of establishing antimicrobial stewardship programmes in two provincial-level hospitals in Vietnam: an implementation research study.

Journal Article BMJ Open · October 1, 2021 OBJECTIVES: To investigate the feasibility of establishing hospital-based antimicrobial stewardship (AMS) programmes comprising action-planning, educational interventions and data feedback in two provincial-level hospitals in Viet Nam. DESIGN AND SETTING: ... Full text Link to item Cite

Significant Regional Differences in Antibiotic Use Across 576 US Hospitals and 11 701 326 Adult Admissions, 2016-2017.

Journal Article Clin Infect Dis · July 15, 2021 BACKGROUND: Quantifying the amount and diversity of antibiotic use in United States hospitals assists antibiotic stewardship efforts but is hampered by limited national surveillance. Our study aimed to address this knowledge gap by examining adult antibiot ... Full text Link to item Cite

Leveraging Existing and Soon-to-Be-Available Novel Diagnostics for Optimizing Outpatient Antibiotic Stewardship in Patients With Respiratory Tract Infections.

Journal Article Clin Infect Dis · June 15, 2021 Respiratory tract infections (RTIs) drive many outpatient encounters and, despite being predominantly viral, are associated with high rates of antibiotic prescriptions. With rising antibacterial resistance, optimization of prescribing of antibiotics in out ... Full text Link to item Cite

A national standard that will influence global efforts to protect antibiotics

Journal Article Journal of Pharmacy Practice and Research · June 1, 2021 Full text Cite

Development of a Machine Learning Model Using Electronic Health Record Data to Identify Antibiotic Use Among Hospitalized Patients.

Journal Article JAMA Netw Open · March 1, 2021 IMPORTANCE: Comparisons of antimicrobial use among hospitals are difficult to interpret owing to variations in patient case mix. Risk-adjustment strategies incorporating larger numbers of variables haves been proposed as a method to improve comparisons for ... Full text Link to item Cite

A modified Delphi approach to develop a trial protocol for antibiotic de-escalation in patients with suspected sepsis.

Journal Article Antimicrob Steward Healthc Epidemiol · 2021 BACKGROUND: Early administration of antibiotics in sepsis is associated with improved patient outcomes, but safe and generalizable approaches to de-escalate or discontinue antibiotics after suspected sepsis events are unknown. METHODS: We used a modified D ... Full text Link to item Cite

Navigating reflex urine culture practices in community hospitals: Need for a validated approach.

Journal Article Am J Infect Control · December 2020 We performed a descriptive study of reflex urine culture (RUC) practices across 51 community hospitals in southeastern United States. We found that 26 unique reflexing criteria were used in 28 hospitals. Only 14% hospitals of hospitals that offered RUC res ... Full text Link to item Cite

Core Recommendations for Antifungal Stewardship: A Statement of the Mycoses Study Group Education and Research Consortium.

Journal Article J Infect Dis · August 5, 2020 In recent years, the global public health community has increasingly recognized the importance of antimicrobial stewardship (AMS) in the fight to improve outcomes, decrease costs, and curb increases in antimicrobial resistance around the world. However, th ... Full text Link to item Cite

Legal implications of antibiotic stewardship programs.

Journal Article Infect Control Hosp Epidemiol · July 2020 Infectious diseases professional societies, public health agencies, and healthcare regulatory agencies call for antibiotic stewardship programs (ASP) in many healthcare settings. However, medical legal implications of these programs remain largely uncharte ... Full text Link to item Cite

Regarding Collaboration in Antimicrobial Stewardship.

Journal Article Infect Dis Clin North Am · March 2020 Full text Link to item Cite

Designing antimicrobial stewardship initiatives to enhance scientific dissemination

Journal Article JACCP Journal of the American College of Clinical Pharmacy · February 1, 2020 Antimicrobial overuse and resistance pose an immediate threat to human health. Antimicrobial stewardship (AMS) refers to efforts designed to improve antimicrobial use and optimize associated outcomes across health care settings. Pharmacists are integral le ... Full text Cite

Reducing Fluoroquinolone Use and Clostridioides difficile Infections in Community Nursing Homes Through Hospital-Nursing Home Collaboration.

Journal Article J Am Med Dir Assoc · January 2020 OBJECTIVE: Nursing homes (NHs) are an important target for antibiotic stewardship (AS). We describe a collaborative model to reduce Clostridioides difficile infections (CDIs) in NHs through optimization of antibiotic use including a reduction in high-risk ... Full text Link to item Cite

Antifungal drugs: Special problems treating central nervous system infections

Journal Article Journal of Fungi · December 1, 2019 Treating fungal infections in the central nervous system (CNS) remains a challenge despite the availability of new antifungal agents. Therapy is limited by poor understanding of the kinetic properties of antifungal drugs in the CNS compounded by lack of da ... Full text Open Access Cite

Impact of FDA black box warning on fluoroquinolone and alternative antibiotic use in southeastern US hospitals.

Journal Article Infect Control Hosp Epidemiol · November 2019 We analyzed antibiotic use data from 29 southeastern US hospitals over a 5-year period to determine changes in antibiotic use after the fluoroquinolone US Food and Drug Administration (FDA) advisory update in 2016. Fluoroquinolone use declined both before ... Full text Link to item Cite

Total duration of antimicrobial therapy resulting from inpatient hospitalization.

Journal Article Infect Control Hosp Epidemiol · August 2019 OBJECTIVE: To assess the feasibility of electronic data capture of postdischarge durations and evaluate total durations of antimicrobial exposure related to inpatient hospital stays. DESIGN: Multicenter, retrospective cohort study. SETTING: Two community h ... Full text Link to item Cite

MRSA nares swab is a more accurate predictor of MRSA wound infection compared with clinical risk factors in emergency department patients with skin and soft tissue infections.

Journal Article Emerg Med J · June 2018 OBJECTIVES: Skin and soft tissue infections (SSTI) caused by methicillin-resistant Staphylococcus aureus (MRSA) are prevalent in the emergency department (ED). We determined whether MRSA nasal carriage better identifies patients with MRSA wound infection t ... Full text Link to item Cite

Feasibility and Value of Developing a Regional Antibiogram for Community Hospitals.

Journal Article Infect Control Hosp Epidemiol · June 2018 OBJECTIVETo determine the feasibility and value of developing a regional antibiogram for community hospitals.DESIGNMulticenter retrospective analysis of antibiograms.SETTING AND PARTICIPANTSA total of 20 community hospitals in central and eastern North Car ... Full text Link to item Cite

Denominator Matters in Estimating Antimicrobial Use: A Comparison of Days Present and Patient Days.

Journal Article Infect Control Hosp Epidemiol · May 2018 Patient days and days present were compared to directly measured person time to quantify how choice of different denominator metrics may affect antimicrobial use rates. Overall, days present were approximately one-third higher than patient days. This diffe ... Full text Link to item Cite

Expert Consensus on Metrics to Assess the Impact of Patient-Level Antimicrobial Stewardship Interventions in Acute-Care Settings.

Journal Article Clin Infect Dis · February 1, 2017 Antimicrobial stewardship programs (ASPs) positively impact patient care, but metrics to assess ASP impact are poorly defined. We used a modified Delphi approach to select relevant metrics for assessing patient-level interventions in acute-care settings fo ... Full text Link to item Cite

Reply to Russotto et al.

Journal Article Current Clinical Microbiology Reports · December 1, 2016 Full text Cite

Antifungal Stewardship: an Emerging Practice in Antimicrobial Stewardship

Journal Article Current Clinical Microbiology Reports · September 1, 2016 Antimicrobial stewardship programs have gained increasing popularity in hospitals worldwide, given the growing emphasis on reducing antimicrobial resistance and data demonstrating inappropriate antibacterial drug use. Data on overuse and opportunities to o ... Full text Cite

Impact of the Pharmacy Practice Model Initiative on Clinical Pharmacy Specialist Practice.

Journal Article Pharmacotherapy · May 2016 This paper describes the goals of the American Society of Health-System Pharmacists' Pharmacy Practice Model Initiative (PPMI) and its recommendations for health-system pharmacy practice transformation to meet future patient care needs and elevate the role ... Full text Link to item Cite

Identification of population at risk for future Clostridium difficile infection following hospital discharge to be targeted for vaccine trials.

Journal Article Vaccine · November 17, 2015 BACKGROUND: Efforts to develop a Clostridium difficile vaccine are underway; identification of patients at risk for C. difficile infection (CDI) is critical to inform vaccine trials. We identified groups at high risk of CDI ≥ 2 8 days after hospital discha ... Full text Link to item Cite

Antifungal Drug Therapeutic Monitoring: What are the Issues?

Journal Article Current Clinical Microbiology Reports · June 1, 2015 Therapeutic drug monitoring (TDM), an established practice for many antimicrobials, has recently seen increasing utilization in the management of patients receiving antifungal agents. There is a growing body of literature supporting the use of TDM for itra ... Full text Cite

Antimicrobial stewardship: philosophy versus practice.

Journal Article Clin Infect Dis · October 15, 2014 To promote the judicious use of antimicrobials and preserve their usefulness in the setting of growing resistance, a number of policy-making bodies and professional societies have advocated the development of antimicrobial stewardship programs. Although th ... Full text Link to item Cite

Voriconazole therapeutic drug monitoring

Journal Article Journal of the Pediatric Infectious Diseases Society · September 1, 2014 A 2-year-old boy being treated for acute lymphoblastic leukemia developed confusion and was found to have a mass on cranial imaging.Aneurosurgical biopsy revealed an aspergilloma. Intravenous (iv) voriconazole is administered at 8 mg/kg per dose twice dail ... Full text Cite

Antimicrobial stewardship: another focus for patient safety?

Journal Article Curr Opin Infect Dis · August 2014 PURPOSE OF REVIEW: This review describes the overlapping aspects of antimicrobial stewardship and patient-safety initiatives and justifies why stewardship belongs under the umbrella of patient safety. RECENT FINDINGS: Addressing the continued emergence of ... Full text Link to item Cite

Vital signs: improving antibiotic use among hospitalized patients.

Journal Article MMWR Morb Mortal Wkly Rep · March 7, 2014 BACKGROUND: Antibiotics are essential to effectively treat many hospitalized patients. However, when antibiotics are prescribed incorrectly, they offer little benefit to patients and potentially expose them to risks for complications, including Clostridium ... Link to item Cite

Cost of invasive fungal infections in the era of new diagnostics and expanded treatment options.

Journal Article Pharmacotherapy · October 2012 STUDY OBJECTIVE: To determine the true institutional cost of treating invasive fungal infections in light of recent advances in diagnostic techniques and antifungal therapies for both treatment and prophylaxis of these infections. DESIGN: Economic analysis ... Full text Link to item Cite

Antimicrobial stewardship: a matter of process or outcome?

Journal Article Pharmacotherapy · August 2012 The risk of antimicrobial resistance and superinfection is increasing alongside rates of hospital-acquired infection. Imprudent antibiotic use combined with few novel antimicrobials can speed resistance. Antimicrobial stewardship programs (ASPs) advocate f ... Full text Link to item Cite

The utility of acute physiology and chronic health evaluation II scores for prediction of mortality among intensive care unit (ICU) and non-ICU patients with methicillin-resistant Staphylococcus aureus bacteremia.

Journal Article Infect Control Hosp Epidemiol · June 2012 OBJECTIVE: Bloodstream infections due to methicillin-resistant Staphylococcus aureus (MRSA) have been associated with significant risk of in-hospital mortality. The acute physiology and chronic health evaluation (APACHE) II score was developed and validate ... Full text Link to item Cite

Pharmacist-managed antimicrobial stewardship program for patients discharged from the emergency department.

Journal Article J Pharm Pract · April 2012 Positive outcomes of antimicrobial stewardship programs in the inpatient setting are well documented, but the benefits for patients not admitted to the hospital remain less clear. This report describes a retrospective case-control study of patients dischar ... Full text Link to item Cite

Predictors of agr dysfunction in methicillin-resistant Staphylococcus aureus (MRSA) isolates among patients with MRSA bloodstream infections.

Journal Article Antimicrob Agents Chemother · December 2011 Despite emerging evidence that dysfunction in the accessory gene regulator (agr) locus is associated with deleterious outcomes among patients treated with vancomycin for methicillin-resistant Staphylococcus aureus (MRSA) infections, factors predictive of a ... Full text Link to item Cite

Pharmacoeconomics of antifungal therapy: Current considerations

Journal Article Current Opinion in Infectious Diseases · August 1, 2011 Purpose of review Invasive fungal infections are a significant cause of morbidity, mortality, and rising healthcare costs. An increasing number of antifungal agents are available to manage these infections, and many of these have a high acquisition price. ... Full text Cite

Antimicrobial stewardship programs in community hospitals: the evidence base and case studies.

Journal Article Clin Infect Dis · August 2011 By controlling and changing how antimicrobial agents are selected and administered, antimicrobial stewardship programs (ASPs) aim to prevent or slow the emergence of antimicrobial resistance; optimize the selection, dosing, and duration of antimicrobial th ... Full text Link to item Cite

Effect of colistin on phospholipid-based activated partial thromboplastin time clotting assay results in patients receiving concomitant heparin therapy.

Journal Article Pharmacotherapy · March 2011 STUDY OBJECTIVE: To determine whether intravenous colistin therapy has an effect on the results of the phospholipid-based activated partial thromboplastin time (aPTT) clotting assays containing cephalin in patients receiving concomitant heparin therapy. DE ... Full text Link to item Cite

Combination antifungal therapy

Journal Article · January 1, 2011 Invasive fungal infections continue to cause significant morbidity and mortality among hospitalized patients. In particular, recent studies indicate an increase in the incidence of mould infections among transplant recipients, and Candida species have rise ... Full text Cite

Nebulizer delivery of micafungin aerosols.

Journal Article Pharmacotherapy · January 2011 STUDY OBJECTIVES: To determine the optimal nebulization system for aerosolizing micafungin and to further assess the physiochemical properties of aerosolized micafungin. DESIGN: In vitro experiment. SETTING: University research center. NEBULIZERS: Pari LC ... Full text Link to item Cite

In vitro characterization of nebulizer delivery of liposomal amphotericin B aerosols.

Journal Article Pharm Dev Technol · 2011 Pharmaceutical aerosols have the potential to prevent pulmonary infectious diseases. Liposomal amphotericin B (LAMB, Ambisome, Astellas Pharma US, Deerfield, IL, USA) is approved as an intravenous infusion for empiric treatment of presumed fungal infection ... Full text Link to item Cite

Alternative therapies for Clostridium difficile infections.

Journal Article Pharmacotherapy · December 2010 Clostridium difficile infection is a serious condition responsible for significant morbidity and mortality, especially in patients being treated with antimicrobials. Increasing frequency of the infection and hypervirulent C. difficile strains have resulted ... Full text Link to item Cite

Management of drug and food interactions with azole antifungal agents in transplant recipients.

Journal Article Pharmacotherapy · August 2010 Azole antifungal agents are frequently used in hematopoietic stem cell and solid organ transplant recipients for prevention or treatment of invasive fungal infections. However, because of metabolism by or substrate activity for various isoenzymes of the cy ... Full text Link to item Cite

Consensus summary of aerosolized antimicrobial agents: application of guideline criteria. Insights from the Society of Infectious Diseases Pharmacists.

Journal Article Pharmacotherapy · June 2010 Aerosolized delivery of antimicrobial agents is an attractive option for management of pulmonary infections, as this is an ideal method of providing high local drug concentrations while minimizing systemic exposure. With the paucity of consensus regarding ... Full text Link to item Cite

Pharmacokinetics of posaconazole administered orally or by nasogastric tube in healthy volunteers.

Journal Article Antimicrob Agents Chemother · July 2009 The use of a nasogastric tube is one means of administering antifungal therapy to critically ill patients unable to receive medication via the oral route. This was a phase 1, open-label, single-center, randomized, crossover study of posaconazole administer ... Full text Link to item Cite

Optimal dosing of fluconazole for treatment of candidemia

Journal Article Current Fungal Infection Reports · June 1, 2009 Full text Cite

Mortality and time to extubation in severe hospital-acquired pneumonia.

Journal Article Am J Infect Control · March 2009 BACKGROUND: This study examined predictors of in-hospital mortality and time to extubation among patients with acute, severe hospital-acquired pneumonia (HAP) managed in the intensive care unit (ICU). METHODS: Patients with HAP prospectively identified bet ... Full text Link to item Cite

Initial characterization of micafungin pulmonary delivery via two different nebulizers and multivariate data analysis of aerosol mass distribution profiles.

Journal Article AAPS PharmSciTech · 2009 Pharmaceutical aerosols have been targeted to the lungs for the treatment of asthma and pulmonary infectious diseases successfully. Micafungin (Astellas Pharma US, Deerfield, IL, USA) has been shown to be an effective antifungal agent when administrated in ... Full text Link to item Cite

Implementation of antibiotic rotation protocol improves antibiotic susceptibility profile in a surgical intensive care unit.

Journal Article J Trauma · August 2007 BACKGROUND: Antibiotic rotation has been proposed as a way to potentially reduce the development of antimicrobial resistant bacteria in intensive care units. We assessed the effect of an antibiotic rotation protocol on the antibiotic susceptibility profile ... Full text Link to item Cite

Comparative pharmacokinetics of voriconazole administered orally as either crushed or whole tablets.

Journal Article Antimicrob Agents Chemother · March 2007 Voriconazole is a triazole antifungal agent used to treat serious, invasive fungal infections including aspergillosis and candidemia. Limitations with existing formulations of voriconazole including restricted utility in patients with renal dysfunction (in ... Full text Link to item Cite

Caspofungin for invasive candidiasis at a tertiary care medical center.

Journal Article Am J Med · November 2006 BACKGROUND: Caspofungin is emerging as first-line therapy for invasive candidiasis. Data on the use of caspofungin for treatment for invasive candidiasis are limited to clinical trials and case reports. We report a single-center experience with 104 consecu ... Full text Link to item Cite

Pharmacology of systemic antifungal agents

Journal Article Clinical Infectious Diseases · August 1, 2006 Traditionally, many invasive fungal infections were associated with a poor prognosis, because effective therapeutic options were limited. The recent development of new antifungal agents has significantly contributed to the successful treatment of fungal di ... Full text Cite

Differential effects of levofloxacin and ciprofloxacin on the risk for isolation of quinolone-resistant Pseudomonas aeruginosa.

Journal Article Antimicrob Agents Chemother · June 2006 Due to the greater in vitro activity of ciprofloxacin than that of levofloxacin against Pseudomonas aeruginosa, the likelihood of isolating a clinical strain of quinolone-resistant (QR) P. aeruginosa might be greater after exposure to levofloxacin than cip ... Full text Link to item Cite

Treatment options for invasive fungal infections.

Conference Pharmacotherapy · June 2006 Clinicians face an increasing occurrence of invasive fungal infections. These are due not only to traditional yeast and mould species but also to rare pathogens that can be difficult to treat. The introduction of new agents has expanded the options for tre ... Full text Link to item Cite

Cost savings with implementation of PNA FISH testing for identification of Candida albicans in blood cultures.

Journal Article Diagn Microbiol Infect Dis · April 2006 Antifungal expenditures are substantial for many hospitals. Using caspofungin for the treatment of candidemia accounts for a sizable proportion of the costs. A cost minimization study that used a decision analytic model was done to compare in-hospital diag ... Full text Link to item Cite

Non-comparative evaluation of the safety of aerosolized amphotericin B lipid complex in patients undergoing allogeneic hematopoietic stem cell transplantation.

Journal Article Transpl Infect Dis · March 2006 Allogeneic hematopoietic stem cell transplant (HSCT) recipients are at increased risk for invasive fungal infections (IFIs) over prolonged periods of time. Aerosolized amphotericin B lipid complex (ABLC) has shown promise in lung transplant recipients as a ... Full text Link to item Cite

Inhaled azithromycin therapy.

Journal Article J Aerosol Med · 2006 The treatment of pulmonary infectious diseases with pharmaceutical aerosols is an attractive option considering the accessibility of the lungs for topical drug delivery. Aerosols have been targeted to the lungs for the treatment of asthma with great succes ... Full text Link to item Cite

Posaconazole.

Journal Article Drugs Today (Barc) · June 2005 Invasive fungal infections are occurring with increasing frequency secondary to medical advances in the areas of transplantation, cancer management and autoimmune diseases. Unfortunately, the currently available antifungal armamentarium does not meet the i ... Full text Link to item Cite

Design of aerosolized amphotericin b formulations for prophylaxis trials among lung transplant recipients.

Journal Article Clin Infect Dis · October 15, 2004 BACKGROUND: Emphasis has been placed on the need for antifungal prophylaxis when transplanted organs are directly exposed to the environment. In lung transplantation, one strategy for prevention has been aerosolization of polyenes into the lung. Despite wi ... Full text Link to item Cite

Risk factors for postoperative mediastinitis due to methicillin-resistant Staphylococcus aureus.

Journal Article Clin Infect Dis · June 1, 2004 Risk factors for developing postoperative mediastinitis (POM) due to methicillin-resistant Staphylococcus aureus (MRSA) were analyzed in a case-case control study of patients who underwent median sternotomy during the period from 1994 through 2000. Three p ... Full text Link to item Cite

Recent advances in antifungal pharmacotherapy for invasive fungal infections.

Journal Article Expert Rev Anti Infect Ther · April 2004 Invasive fungal infections carry significant morbidity and mortality. Candida species have become one of the most frequent causes of bloodstream infections, and infections caused by molds such as Aspergillus are becoming more frequent in immunocompromised ... Full text Link to item Cite

Aspergillus fumigatus empyema, arthritis, and calcaneal osteomyelitis in a lung transplant patient successfully treated with posaconazole.

Journal Article J Clin Microbiol · March 2004 A 64-year-old male with Aspergillus fumigatus infection that had disseminated from the lung to the ankle and adjacent bone was treated successfully with posaconazole after therapy with itraconazole and amphotericin B lipid complex failed. Marked clinical i ... Full text Link to item Cite

Comparative safety of amphotericin B lipid complex and amphotericin B deoxycholate as aerosolized antifungal prophylaxis in lung-transplant recipients.

Journal Article Transplantation · January 27, 2004 BACKGROUND: Aerosolized administrations of amphotericin B deoxycholate (AmBd) and amphotericin B lipid complex (ABLC) in lung transplant recipients were compared for safety and tolerability. The incidence of invasive fungal infections in patients receiving ... Full text Link to item Cite

Rational use of antifungals for invasive fungal infections in the institutional setting

Chapter · January 1, 2004 The incidence of invasive fungal infections (IFIs) is increasing at an alarming rate. In the past decade alone, Candida spp. have become the fourth leading cause of nosocomial bloodstream infections in the United States (1). The incidence of Aspergillus in ... Cite

Antifungal pharmacotherapy for invasive mould infections.

Journal Article Expert Opin Pharmacother · February 2003 The incidence of invasive mould infections is increasing and is associated with significant morbidity and mortality. Among the most prevalent of these infections are those caused by Aspergillus and Fusarium species. Invasive disease caused by moulds freque ... Full text Link to item Cite