286. Infectious Complications and Antimicrobial Utilization in Hospitalized Patients with COVID-19

Abstract Background Hospitalized patients with COVID-19 have created increased demands on health care infrastructure and resources. Bacterial and fungal infections have been reported and have increased the need for antimicrobial utilization. We performed a retrospective chart review to characterize bacterial infections and antibiotic utilization during the COVID-19 surge at our tertiary care center. Methods All patients diagnosed with COVID-19 using SARS-CoV-2 PCR admitted to MedStar Georgetown University Hospital from 01Mar2020 through 31Aug2020 were included in the analysis. Data was collected on hospital-wide antimicrobial utilization [mean days of therapy per 1000-patient-days (DOT)] during the 6-month surge and was compared to antimicrobial utilization during a 6-month period that preceded the COVID-19 surge. Clinical and microbiological data and patient outcomes were also collected and analyzed. Results A total of 238 patients met eligibility criteria during the observation period, of which 25.6% (n = 61) developed a bacterial, fungal, or viral co-infection. Culture-positive bacterial complications were seen in 21.8% (n = 52) with 32.8% (n = 20) having a multidrug resistant organism (MDRO). There was a statistically significant difference between COVID-19 patients with co-infection and those without for intubation (p < 0.001), vasopressor use (p < 0.001), and renal replacement therapy (p = 0.001). COVID-19 patients with co-infections had a longer mean length of stay (21.9 days vs 13.5 days, p < 0.001) and greater mortality (32.8% vs 20.6%, p = 0.006) compared to those without a co-infection, respectively. Mean antimicrobial utilization for the entire hospital population was 790.6 DOT during the COVID surge compared to 928.7 DOT during a 6-month period preceding the COVID surge (p < 0.001). For all COVID-19 patients, antimicrobial utilization was 846.9 DOT; however, this increased to 1236.4 DOT for COVID-19 patients with co-infections. Table 1. Demographics Table 2. Antimicrobial Utilization in COVID-19 Patients Conclusion Although hospital-wide antimicrobial utilization had decreased during the COVID surge, COVID-19 patients with co-infections demonstrated a disproportionate use of antimicrobial agents as well as ICU resources. As MDRO infections were relatively common, antimicrobial stewardship should be prioritized in the COVID-19 population. Disclosures Lan Duong, Pharm.D., Astra Zeneca (Shareholder)Eli Lilly & Co. (Shareholder)Gilead Sciences, Inc. (Shareholder)Merck & Co. (Speaker’s Bureau)Moderna, Inc. (Shareholder)Novavax, Inc. (Shareholder)Sarepta Therapeutics (Shareholder)Thermo Fisher Scientific (Shareholder) Princy N. Kumar, MD, AMGEN (Other Financial or Material Support, Honoraria)Eli Lilly (Grant/Research Support)Gilead (Grant/Research Support, Shareholder, Other Financial or Material Support, Honoraria)GSK (Grant/Research Support, Shareholder, Other Financial or Material Support, Honoraria)Merck & Co., Inc. (Grant/Research Support, Shareholder, Other Financial or Material Support, Honoraria)

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Seroprevalence of anti-SARS-CoV-2 IgG antibodies in hospitalized patients at a tertiary referral center in North India (Preprint)

10.2196/preprints.23937 ◽

2020 ◽

Author(s):

Dr. Animesh Ray ◽

Dr. Komal Singh ◽

Souvick Chattopadhyay ◽

Farha Mehdi ◽

Dr. Gaurav Batra ◽

...

Keyword(s):

Tertiary Care ◽

Age Groups ◽

Hospitalized Patients ◽

North India ◽

P Value ◽

Care Hospital ◽

Igg Antibodies ◽

Igg Antibody ◽

Increased Risk ◽

Significant Difference

BACKGROUND Seroprevalence of IgG antibodies against SARS-CoV-2 is an important tool to estimate the true extent of infection in a population. However, seroprevalence studies have been scarce in South East Asia including India, which, as of now, carries the third largest burden of confirmed cases in the world. The present study aimed to estimate the seroprevalence of anti-SARS-CoV-2 IgG antibody among hospitalized patients at one of the largest government hospital in India OBJECTIVE The primary objective of this study is to estimate the seroprevalence of SARS-CoV-2 antibody among patients admitted to the Medicine ward and ICU METHODS This cross-sectional study, conducted at a tertiary care hospital in North India, recruited consecutive patients who were negative for SARS-CoV-2 by RT-PCR or CB-NAAT. Anti-SARS-CoV-2 IgG antibody levels targeting recombinant spike receptor-binding domain (RBD) protein of SARS CoV-2 were estimated in serum sample by the ELISA method RESULTS A total of 212 hospitalized patients were recruited in the study with mean age (±SD) of 41.2 (±15.4) years and 55% male population. Positive serology against SARS CoV-2 was detected in 19.8%patients(95% CI 14.7-25.8). Residency in Delhi conferred a higher frequency of seropositivity 26.5% (95% CI 19.3-34.7) as compared to that of other states 8% (95% CI 3.0-16.4) with p-value 0.001. No particular age groups or socio-economic strata showed a higher proportion of seropositivity CONCLUSIONS Around, one-fifth of hospitalized patients, who were not diagnosed with COVID-19 before, demonstrated seropositivity against SARS-CoV-2. While there was no significant difference in the different age groups and socio-economic classes; residence in Delhi was associated with increased risk (relative risk of 3.62, 95% CI 1.59-8.21)

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Post-Stroke Depression and Its Effect on Functional Outcomes during Inpatient Rehabilitation

Journal of Neurosciences in Rural Practice ◽

10.1055/s-0041-1731958 ◽

2021 ◽

Author(s):

Gurumayum Sonachand Sharma ◽

Anupam Gupta ◽

Meeka Khanna ◽

Naveen Bangarpet Prakash

Keyword(s):

Outcome Measures ◽

Functional Outcomes ◽

Rating Scale ◽

Tertiary Care ◽

Depression Scale ◽

Inpatient Rehabilitation ◽

University Hospital ◽

Post Stroke ◽

Significant Difference ◽

Post Stroke Depression

Abstract Objective The aim of the study is to observe the effect of post-stroke depression on functional outcomes during inpatient rehabilitation. Patients and Methods The design involved is prospective observational study. The location involved is Neurological Rehabilitation unit in a tertiary care university hospital. The study period ranges from October 2019 to April 2020. The participants involved are the patients with first ever stroke, male and female with age ≥18 years and duration less than 1 year. All participants were assessed at admission and after 14 sessions of inpatient rehabilitation by depression subscale of Hospital Anxiety and Depression Scale (HADS-D) and Hamilton Depression Rating Scale (HDRS). The stroke outcomes measures used were: Barthel Index (BI), Scandinavian Stroke Scale (SSS), and Modified Rankin Scale (MRS). Results There are a total of 30 participants (18 males) with median stroke duration of 90 days. The median age of the patients was 58 years. Sixteen patients had ischemic and 14 had hemorrhagic stroke. Out of these, 57% (n = 17) had symptoms of depression (HADS-D >7). Participants in both groups (with and without depression) showed improvement in all the functional outcome measures (BI, SSS, MRS) at the time of discharge as compared with admission scores. The changes in the outcome measures were statistically significant within groups (p < 0.05) but not significant between the groups (p > 0.05). Conclusion The post-stroke depression is common among stroke survivors of less than 1 year duration. There was no significant difference in the functional outcomes between stroke patients with depression and those without depression with inpatient rehabilitation program.

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How Does Antimicrobial Resistance Increase Medical Costs in Community-Acquired Acute Pyelonephritis?

Antimicrobial Stewardship & Healthcare Epidemiology ◽

10.1017/ash.2021.42 ◽

2021 ◽

Vol 1 (S1) ◽

pp. s23-s23

Author(s):

Bongyoung Kim ◽

Taul Cheong ◽

Jungmo Ahn

Keyword(s):

Antimicrobial Resistance ◽

Linear Regression ◽

Acute Pyelonephritis ◽

Tertiary Care ◽

Medical Costs ◽

Hospitalized Patients ◽

Care Hospital ◽

Causative Pathogen ◽

Significant Difference ◽

Log Linear

Background: The proportion of antimicrobial-resistant Enterobacterales that are causative pathogens for community-acquired acute pyelonephritis (CA-APN) has been increasing. We examined the effect of antimicrobial resistance on medical costs in CA-APN. Methods: A single-center retrospective cohort study was conducted at a tertiary-care hospital in Korea between January 2018 to December 2019. All hospitalized patients aged ≥19 years who were diagnosed with CA-APN were recruited, and those with Enterobacterales as a causative pathogen were included. Comparisons between CA-APN caused by extended-spectrum β-lactamase (ESBL)–producing pathogens (ESBL+ group) and those by non–ESBL-producing organisms (ESBL– group) as well as CA-APN caused by ciprofloxacin-resistant pathogens (CIP-R group) and those by ciprofloxacin-sensitive pathogens (CIP-S group) were performed. Log-linear regression was performed to determine the risk factors for medical costs. Results: In total, 241 patients were included in this study. Of these, 75 (31.1%) had an ESBL-producing pathogen and 87 (36.1%) had a ciprofloxacin-resistant pathogen. The overall medical costs were significantly higher in the ESBL+ group compared with the ESBL− group (US$3,730.18 vs US$3,119.32) P <0.001) as well as in CIP-R group compared with CIP-S group (3,730.18 USD vs. 3,119.32 USD, P =0.005). In addition, length of stay was longer in ESBL+ group compared with ESBL-group (11 vs. 8 days, P <0.001) as well as in CIP-R group compared with CIP-S group (11 vs. 8 days, P <0.001). There were no significant difference in the proportion of clinical failure between ESBL+ and ESBL- groups; CIP-R and CIP-S groups. Based on the log-linear regression model, the costs associated with ESBL-producing Enterobacterales as the causative pathogen would be, on average, 27% higher or US$1,211 higher than its counterpart (P = .026). By the same token, a patient who is a year older would incur US$23 higher cost (P = .040). Having any structural problem in urinary tract would incur US$1,231 higher cost (P = .015). A unit increase in Pitt score would incur US$767 USD higher cost (P < 0.001) higher cost, all other things constant. Conclusions: Medical costs for hospitalized patients with CA-APN are increased by the existence of ESBL-producing Enterobacterales but not by the existence of ciprofloxacin-resistant Enterobacterales.Funding: NoDisclosures: None

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Vancomycin-resistance Enterococcal Colonization in Hospitalized Patients in Relation to Antibiotic Usage in a Tertiary Care Hospital of North India

Journal of Laboratory Physicians ◽

10.4103/0974-2727.163123 ◽

2015 ◽

Vol 7 (02) ◽

pp. 108-111 ◽

Cited By ~ 1

Author(s):

Tuhina Banerjee ◽

Shampa Anupurba ◽

Joel Filgona ◽

Dinesh K Singh

Keyword(s):

Risk Factors ◽

Multivariate Analysis ◽

Tertiary Care ◽

Significant Risk ◽

Antibiotic Use ◽

Antibiotic Usage ◽

Hospitalized Patients ◽

University Hospital ◽

North India ◽

Care Hospital

ABSTRACT Background: Alarming rise of vancomycin-resistant enterococci (VRE) is a global cause of concern. Several factors have been held responsible for such rise, of which antibiotic usage is a prominent one. Objectives: This study was undertaken to determine the intestinal VRE colonization rate amongst hospitalized patients in relation to use of various antibiotics in the Intensive Care Unit (ICU) of a tertiary care university hospital, India. Materials and Methods: Stool samples were collected weekly from all the patients in the adult ICU for a period of 6 months and processed for isolation and phenotypic and genotypic characterization of VRE isolates. Patient and treatment details were noted and cases (those with VRE in stool) and controls (those without VRE in stool) were compared statistically. Further, a multivariate analysis was done to identify those antibiotics as independent risk factors for VRE colonization. Results: VRE colonization was found in 34.56% (28/81) of the patients studied, with the majority 75% (21/28) carrying the vanA gene. The cases had significantly more (P < 0.05) duration of hospital stay and antibiotic exposure. Intake of metronidazole, vancomycin, and piperacillin-tazobactam were identified as significant risk factors both in univariate and multivariate analysis. Conclusion: A potential reservoir of VRE was thus revealed even in low VRE prevalence setting. Based on this high colonization status, restriction of empirical antibiotic use, reviewing of the ongoing antibiotic policy, and active VRE surveillance as an integral part of infection control strategy were suggested.

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Surgical-site infections in emergency abdominal paediatric surgeries at a tertiary-care hospital in Pakistan

Journal of the Pakistan Medical Association ◽

10.47391/jpma.1107 ◽

2020 ◽

pp. 1-9

Author(s):

Ali Faisal Saleem ◽

Huma Faiz Halepota ◽

Hasaan Omar ◽

Areeba Zain ◽

Muhammad Arif Mateen Khan

Keyword(s):

Abdominal Surgery ◽

Surgical Site Infection ◽

Tertiary Care ◽

Stable Condition ◽

University Hospital ◽

P Value ◽

Care Hospital ◽

Site Infection ◽

Significant Difference ◽

Pathogen Occurrence

Abstract A retrospective chart review was carried out in children (neonates to 18 years) who underwent acute surgical abdominal exploration during 2012-2016 at the Aga Khan University Hospital, Karachi, to evaluate the post-operative surgical site infection rates in emergency paediatric abdominal surgery. Incidence of surgical site infection (SSI) was estimated. P-value was calculated, chi-square and non-parametric tests were performed by comparing pre-surgical and post-surgical procedure pathogen occurrence and pre-procedure wound status. Pathogen occurrence related to time-trend of 98 paediatric patients who underwent emergency abdominal surgery was plotted. Of the 94 who were discharged in stable condition, it was found that there was no significant difference between pre- and post-surgical pathogens. Escherichia coli (n=10) was found to be the most common pathogen. Contaminated wounds were associated with higher SSI (p=0.036, OR 1.95 95% CI 0.7-5.4). Continuous...

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297. Infectious Complications Associated with Tocilizumab Use in Patients Infected with SARS-CoV-2 at a Mid-Atlantic Hospital Consortium

Open Forum Infectious Diseases ◽

10.1093/ofid/ofab466.499 ◽

2021 ◽

Vol 8 (Supplement_1) ◽

pp. S256-S256

Author(s):

Kristen R Kent ◽

Nellie Darling ◽

Xue Geng ◽

Gavin Clark ◽

Marybeth Kazanas ◽

...

Keyword(s):

Statistical Significance ◽

Post Treatment ◽

Risk Of Infection ◽

Research Support ◽

Candida Spp ◽

Gram Positive ◽

Gram Negative ◽

Material Support ◽

Increased Risk ◽

Significant Difference

Abstract Background The IL-6 inhibitor Tocilizumab (TOCI) has been associated with infections in 5-8% of patients with Rheumatoid Arthritis. TOCI has now been recommended as a treatment option for select patients with COVID-19; however, the risk of infection in this patient population is yet to be determined. Methods We performed a retrospective chart review of patients diagnosed with COVID-19 and admitted to MedStar hospitals within the D.C./Baltimore corridor from 03/01/2020 to 12/31/2020. We identified patients who had positive culture data within 30 days of administration of TOCI-based regimens and analyzed clinical characteristics and outcomes. Univariate analyses (Wilcoxon, T-test, Chi-Square, Fisher’s Exact) were used to compare these outcome variables between patients who had post-treatment infections and those who did not. Results A total of 220 patients received TOCI-based regimens; 16% (N=36) of patients developed positive cultures within 30 days of treatment. Of the 99 cultures, 50% were gram positive (N=49), 38% were gram negative (N=38), 10% were Candida spp. (N=10), and 2% were anaerobic organisms (N=2). Only 9% (8/87) of the gram positive and gram negative organisms were MDROs. Bloodstream infections were the most common and accounted for 58.4% of all infections. Length of stay (LOS) was approximately twice as long in those with post-treatment infections (26 days) compared to those without infections (14 days, p< 0.001). Although the mortality rate was higher in patients with infections after TOCI-based treatment compared to patients with no post-treatment infection (47% vs 31% respectively), this did not reach statistical significance (p=0.09). Moreover, there was no significant difference in the infection rate of patients treated with TOCI alone compared to TOCI and Dexamethasone (16.6% vs. 13.3%, p=0.99). No cases of invasive Aspergillosis were observed. Conclusion Tocilizumab treatment in patients with COVID-19 may predispose patients to an increased risk of infection which is associated with a prolonged LOS and possibly higher mortality. We observed a two-fold increase in infections in COVID-19 patients compared to other patient groups receiving this treatment. Disclosures Princy N. Kumar, MD, AMGEN (Other Financial or Material Support, Honoraria)Eli Lilly (Grant/Research Support)Gilead (Grant/Research Support, Shareholder, Other Financial or Material Support, Honoraria)GSK (Grant/Research Support, Shareholder, Other Financial or Material Support, Honoraria)Merck & Co., Inc. (Grant/Research Support, Shareholder, Other Financial or Material Support, Honoraria)

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1141. Implementation of a Pediatric Handshake Antimicrobial Stewardship Program to Improve Antimicrobial Utilization

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.1005 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S406-S406

Author(s):

Amanda P Hughes ◽

Maya Beganovic ◽

Ronda Oram ◽

Sarah Wieczorkiewicz ◽

Anthony Chiang

Keyword(s):

Antimicrobial Stewardship ◽

Audit And Feedback ◽

Prescribing Practices ◽

Stewardship Program ◽

Antimicrobial Utilization ◽

Days Of Therapy ◽

Significant Difference ◽

Acceptance Rates ◽

Prospective Audit And Feedback ◽

The Impact

Abstract Background Antimicrobial stewardship (AMS) programs emerged in response to rising rates of resistance and adverse effects associated with inappropriate antimicrobial utilization. Optimal metrics and strategies (e.g., preauthorization, prospective audit and feedback) for AMS remain to be elucidated. This study evaluated the impact of a multidisciplinary, rounding-based AMS strategy (i.e., Handshake Stewardship) on antimicrobial utilization and prescribing practices at a pediatric hospital. Methods This was a single-center, retrospective quality improvement study at a community, teaching children’s hospital. All pediatric and neonatal inpatients with active antimicrobial orders between July 2018 and March 2019 were included in the study, and endpoints were compared with data from July 2017- March 2018. Antimicrobial courses were prospectively audited by a multidisciplinary AMS team, and feedback was provided to the primary teams during Handshake Stewardship rounds. The primary endpoint was a number of interventions made and the corresponding acceptance rates. The secondary endpoint was days of therapy (DOT) per 1000 patient-days. Descriptive statistics were performed on all continuous and categorical data as appropriate. Results Of 2238 antimicrobial courses reviewed, 710 (32%) required intervention, and 86% of the interventions made were accepted. The top 3 indications evaluated were respiratory (n = 522, 23%), sepsis/bacteremia (n = 351, 16%), and surgical prophylaxis (n = 266, 12%). Of the respiratory courses reviewed, there were 228 opportunities for antimicrobial optimization. The most common interventions were: bug-drug optimization (n = 208, 29%), discontinuation of anti-infective (n = 136, 19%), and dose optimization (n = 120, 17%). No significant difference was observed for overall, ceftriaxone, meropenem, and vancomycin DOT pre- and post-implementation of Handshake Stewardship. However, a statistically significant reduction in DOTs was observed for piperacillin–tazobactam (15.2 vs. 7.4, P = 0.004) and a nonsignificant reduction in meropenem (9.5 vs. 6.2). Conclusion Rounding-based, Handshake AMS was associated with overall high intervention acceptance rates and a reduction in commonly utilized broad-spectrum antimicrobials. Disclosures All authors: No reported disclosures.

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Contamination assessment of orthodontic bands after different pre-cleaning methods at a tertiary care hospital

Journal of Orthodontics ◽

10.1177/1465312519855402 ◽

2019 ◽

Vol 46 (3) ◽

pp. 220-224 ◽

Cited By ~ 1

Author(s):

Sarah Irfan ◽

Seema Irfan ◽

Mubassar Fida ◽

Israr Ahmad

Keyword(s):

Bacterial Growth ◽

Bacterial Species ◽

Tertiary Care ◽

Brain Heart Infusion ◽

University Hospital ◽

Growth Effect ◽

Care Hospital ◽

Contamination Assessment ◽

Significant Difference ◽

Cleaning Methods

Introduction: Infection control in dentistry is a major concern due to risk of transmission of communicable diseases. The aim of this study is to evaluate and compare the efficacy of various pre-cleaning methods for the tried-in orthodontic bands. Material and methods: An in-vitro experimental study was conducted at the Central Sterilization Services Department (Dental Clinic) and the Microbiology lab at our university hospital. A total of 130 bands were included in our study which comprised 10 controls and the rest were equally divided into three groups according to the pre-cleaning methods, i.e. manual scrubbing, enzymatic solution and a combination of both. The orthodontic bands were incubated in the brain heart infusion broth at 37 °C for five days after pre-cleaning and sterilisation in a steam autoclave and were assessed for any bacterial growth. The chi-square test was applied to determine any significant association between the various pre-cleaning methods and the frequency of bands that showed growth. Effect size was calculated using the phi coefficient. Results: The enzyme method revealed 5% of the sample to exhibit bacterial growth, whereas manual scrubbing and the combination of both showed no growth. There was no statistically significant difference among the three methods ( P = 0.131). Further investigations showed the presence of Staphylococcus non-aureus bacterial species in contaminated bands from group II. Conclusions: All pre-cleaning methods were found to be equally effective in the decontamination of bands. Hence, the tried-in bands can be safely reused after pre-cleaning and sterilisation.

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Emergence of Vancomycin-Resistant Enterococci at a University Hospital in Taiwan: Persistence of Multiple Species and Multiple Clones

Infection Control and Hospital Epidemiology ◽

10.1086/501592 ◽

1999 ◽

Vol 20 (12) ◽

pp. 828-833 ◽

Cited By ~ 26

Author(s):

Po-Ren Hsueh ◽

Lee-Jene Teng ◽

Hui-Ju Pan ◽

Yu-Chi Chen ◽

Li-Hua Wang ◽

...

Keyword(s):

Hospital Admissions ◽

Tertiary Care ◽

Perianal Abscess ◽

Antibiotic Use ◽

Hospitalized Patients ◽

The Other ◽

University Hospital ◽

Vancomycin Resistant Enterococci ◽

Vancomycin Resistant ◽

Multiple Species

AbstractObjectives:To describe the epidemiology of vancomycin-resistant enterococci (VRE) in a university hospital in Taipei, Taiwan.Design:Retrospective review over a 27-month period, from March 1996 to May 1998.Setting:A tertiary-care teaching hospital in Taiwan.Participants:Patients with VRE isolated from any body site.Methods:Patients were identified through hospital microbiology and infection control records. Patient charts were reviewed for clinical and epidemiology data, including age, gender, previous hospital admissions, underlying diseases, types of infection, and recent antibiotic use. VRE isolates were characterized by their typical biochemical reactions, cellular fatty acid profiles, and the presence ofvangenes. Antibiotypes using the E-test and randomly amplified polymorphic DNA (RAPD) patterns of these isolates were used to determine the clonality.Results:Twenty-five isolates of VRE recovered from 12 patients were identified. One patient with a perianal abscess had 12 isolates of VRE (4Enterococcus faecalis, 7Enterococcus faecium, and 1Enterococcus casseliflavus) recovered from perianal lesions. Among 3 patients who were hospitalized in the same room, 1 had a community-acquired cellulitis over the left leg caused byE faecalis, and the other 2 patients both had anal colonization with 2 isolates ofE faecalis. The other 8 patients had 1E faecalisisolate each from various clinical specimens. All isolates possessed vanA resistance phenotype andvanAgenes. Different antibiotypes and RAPD patterns of the isolates from different patients excluded the possibility of nosocomial spread at the hospital.Conclusions:Multiple species of VRE (E faecalis, E faecium, andE casseliflavus) and multiple clones ofE faeciumcould colonize or infect hospitalized patients. In addition, clones of VRE can persist long-term in patients' lower gastrointestinal tracts. These results extend our knowledge of the coexistence and the persistence of multiple species and multiple clones of VRE in hospitalized patients.

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Impact of the inpatient infectious disease consultations at a tertiary care university hospital

10.21203/rs.2.17410/v1 ◽

2019 ◽

Author(s):

Rami Waked ◽

Danielle Jaafar ◽

Marie Chedid ◽

Gebrael Saliba ◽

Elie Haddad ◽

...

Keyword(s):

Infectious Disease ◽

Infectious Diseases ◽

Tertiary Care ◽

Antibiotic Use ◽

Hospitalized Patients ◽

University Hospital ◽

Therapeutic Approaches ◽

Infectious Diseases Consultation ◽

Disease Specialist

Abstract The role of the infectious disease specialist continues to evolve. The purpose of this study is to demonstrate the value of infectious disease consultation in the inpatient setting.METHODS This is a prospective cohort study that took place in a tertiary care university hospital. During the period from April to June 2016, 224 cases of patients receiving antibiotics in the hospital with the request of an infectious diseases’ consultation, were evaluated. The following variables were assessed: the referring department, purpose of the consultation, the antibiotic used before requesting the infectious diseases consultation, the antibiotic modifications after the infectious disease’s visit (changing the type, dose or range of the antibiotic when applicable, modifying the duration of antibiotic use), whenever the antibiotic usage was switched to a mono or bi-therapy.RESULTS The most frequent requesting departments were Oncology (23.2%) and Urology (21.4%). The purpose of the consultations was diagnosis (29%), therapy (41%), both diagnosis and therapy (21%), and prophylaxis (9%). An infectious diseases consultation was given at a rate of 4.9 consultations per 100 hospitalized patients. Antibiotic was discontinued in 14.7% of cases. There was no indication for the antibiotic treatment in 11.6% of cases. Modifying the antibiotic therapy was done in 25.4% of cases. Adjusting the antibiotic dosage was done in only one case. Carbapenem antibiotics were discontinued in 31.6% of cases and Quinolones discontinuation accounted for 22.7% of cases.CONCLUSION Infectious disease consults contributed to the optimization of the diagnostic and therapeutic approaches for suspected or confirmed infections in hospitalized patients.

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