An Amateur's Introduction to Recursive Query Processing Strategies ††This is a revised version of a paper that appeared under the same title in the proceedings of SIGMOD 86. This work was performed while the first author was at MCC, Austin, and the second author was at the University of Texas at Austin and visiting MCC.

As a publicly funded institution,The University of Texas at Austin had to implement the state's legislation to allow concealed handguns on campus. Yet its own Campus Carry policy has sought to erase the matter from everyday campus life. The administration deems it a “nonissue,” presuming that students have become accustomed to the idea, do not think about it actively, and have a low interest in acquiring a handgun license. This paper, based on a survey of the university's undergraduates, questions these ideas. It shows that a majority of students think that the issue is important and examines in what sense the students are troubled by its effects. While opinions differ between supporters and opponents of Campus Carry, divergences also exist within their ranks, such as among supporters of the law regarding where guns should specifically be allowed at the university. On the basis of the survey, the essay also examines how many licensed carriers are actually on campus, compared to the university's estimates.

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44. Antibiotic Class-Based Distribution and Analysis of Reported Beta-Lactam Allergies amongst Hospitalized Patients

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.089 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S45-S45

Author(s):

Joseph Patrik Hornak ◽

David Reynoso

Keyword(s):

Bacterial Infections ◽

Drug Resistant ◽

Beta Lactam ◽

Resistance Development ◽

Texas Medical ◽

University Of Texas ◽

Icd 10 ◽

Mrsa Infection ◽

The University ◽

Alternative Antibiotic

Abstract Background Reported β-lactam allergy (BLA) is very common, yet less than 10% of these patients exhibit true hypersensitivity. When faced with reported BLAs, physicians often choose alternative antibiotics which can be associated with C. difficile infection, drug-resistance development, poorer outcomes, & increased costs. Effective identification of these patients is necessary for subsequent, appropriate BLA “de-labeling.” Here, we conducted a single-center analysis of alternative antibiotic utilization amongst patients reporting BLA and compare the frequency of drug-resistant infections and C. difficile infection in allergic & non-allergic patients. Methods This is a retrospective review of adult patients hospitalized at The University of Texas Medical Branch from 1/1/2015 to 12/31/2019. Pooled electronic medical records were filtered by antibiotic orders and reported allergies to penicillins or cephalosporins. Patients with drug-resistant and/or C. difficile infection (CDI) were identified by ICD-10 codes. Microsoft Excel & MedCalc were used for statistical calculations. Results Data were available for 118,326 patients and 9.3% (11,982) reported a BLA, with the highest rates seen in those receiving aztreonam (85.9%, 530/617) & clindamycin (33.7%, 3949/11718). Amongst patients reporting BLA, high ratios-of-consumption (relative to all patients receiving antibiotics) were seen with aztreonam (7.0), clindamycin (2.7), cephalosporin/β-lactamase inhibitors (2.4), & daptomycin (2.1). Compared to the non-BLA population, BLA patients more frequently experienced MRSA infection (3.0% vs 1.5%, OR 1.99, 95% CI 1.79–2.23, p< 0.0001), β-lactam resistance (1.2% vs 0.6%, OR 2.07, 95% CI 1.72–2.49, p< 0.0001), and CDI (1.2% vs 0.7%, OR 1.85, 95% CI 1.54–2.23, p< 0.0001). Conclusion Our measured BLA rate matches approximate expectations near 10%. Moreover, these patients experienced significantly higher frequencies of drug-resistant bacterial infections and CDI. Targeted inpatient penicillin allergy testing stands to be particularly effective in those patients receiving disproportionately utilized alternative agents (e.g. aztreonam, clindamycin, daptomycin). β-lactam allergy “de-labeling” in these patients is likely a valuable antimicrobial stewardship target. Disclosures All Authors: No reported disclosures

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