||One of the greatest medical advances of the 20st century was the discovery of antibiotics, and one of the gravest medical threats of the 21st century is antibiotic resistance, largely driven by overuse of antibiotics. Many factors contribute to the overuse of antibiotics including societal expectation, misdiagnosis of infection, and lack of knowledge surrounding risks and benefits. Barbara Jones, MD, and Matthew Samore, MD, used national data from the Department of Veterans Affairs to examine decision-making and practice patterns among providers prescribing antibiotics for patients diagnosed with acute respiratory infection. Their research team demonstrated considerable variability in provider's antibiotic prescribing practices as well as in their accuracy diagnosing patients with suspected pneumonia. They then assessed the effect of treatment choice on outcomes. The found that empirical broad-spectrum antibiotics targeting methicillin-resistant Staphylococcus aureus were associated with increased mortality in patients hospitalized for pneumonia. Current work is focused on providing clinicians with evidence-based decision support and feedback to support better clinical decisions.
||1.) Variation in outpatient antibiotic prescribing for acute respiratory infections in the veteran population: a cross-sectional study. Jones BE, Sauer B, Jones MM, Campo J, Damal K, He T, Ying J, Greene T, Goetz MB, Neuhauser MM, Hicks LA, Samore MH. Ann Intern Med. 2015 Jul 21;163(2):73. PMID: 26192562. 2.) Development and validation of a natural language processing tool to identify patients treated for pneumonia across VA emergency departments. Jones BE, South BR, Shao Y, Lu CC, Leng J, Sauer BC, Gundlapalli AV, Samore MH, Zeng Q. Appl Clin Inform. 2018 Jan;9(1):122. doi: 10.1055/s-0038-1626725. Epub 2018 Feb 21. PMID: 29466818; PMCID: PMC5821510. 3.) Variation in empiric coverage versus detection of methicillin-resistant staphylococcus aureus and pseudomonas aeruginosa in hospitalizations for community-onset pneumonia across 128 us Veterans Affairs medical centers. Jones BE, Brown KA, Jones MM, Huttner BD, Greene T, Sauer BC, Madaras-Kelly K, Rubin MA, Bidwell Goetz M, Samore MH. Infect Control Hosp Epidemiol. 2017 Aug;38(8):937. doi: 10.1017/ice.2017.98. Epub 2017 Jun 21. PMID: 28633678. 4.) Trends in antibiotic use and nosocomial pathogens in hospitalized veterans with pneumonia at 128 medical centers, 2006-2010. Jones BE, Jones MM, Huttner B, Stoddard G, Brown KA, Stevens VW, Greene T, Sauer B, Madaras-Kelly K, Rubin M, Goetz MB, Samore M. Clin Infect Dis. 2015 Nov 1;61(9):1403. doi: 10.1093/cid/civ629. Epub 2015 Jul 29. PMID: 26223995; PMCID: PMC4599396. 5.) Empirical anti-mrsa vs standard antibiotic therapy and risk of 30-day mortality in patients hospitalized for pneumonia. Jones BE, Ying J, Stevens V, Haroldsen C, He T, Nevers M, Christensen MA, Nelson RE, Stoddard GJ, Sauer BC, Yarbrough PM, Jones MM, Goetz MB, Greene T, Samore MH. JAMA Intern Med. 2020 Apr 1;180(4):552.