{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:16:16Z","timestamp":1788999376367,"version":"build-2803163510"},"reference-count":16,"publisher":"Cambridge University Press (CUP)","issue":"1","license":[{"start":{"date-parts":[[2022,3,10]],"date-time":"2022-03-10T00:00:00Z","timestamp":1646870400000},"content-version":"unspecified","delay-in-days":68,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ASHE"],"published-print":{"date-parts":[[2022]]},"abstract":"<jats:title>Abstract<\/jats:title>\n\t  <jats:sec id=\"S2732494X22000146_as1\">\n\t    <jats:title>Objective:<\/jats:title>\n\t    <jats:p>Methicillin-resistant <jats:italic>Staphylococcus aureus<\/jats:italic> (MRSA) infection is highly unlikely when nasal-swab results are negative. We evaluated the impact of an electronic prompt regarding MRSA nasal screening on the length of vancomycin therapy for respiratory indications.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2732494X22000146_as2\">\n\t    <jats:title>Design:<\/jats:title>\n\t    <jats:p>Retrospective, single-center cohort study.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2732494X22000146_as3\">\n\t    <jats:title>Setting:<\/jats:title>\n\t    <jats:p>Tertiary-care academic medical center (Mayo Clinic) in Jacksonville, Florida.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2732494X22000146_as4\">\n\t    <jats:title>Patients:<\/jats:title>\n\t    <jats:p>Eligible patients received empiric treatment with vancomycin for suspected or confirmed respiratory infections from January through April 2019 (preimplementation cohort) and from October 2019 through January 2020 (postimplementation cohort).<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2732494X22000146_as5\">\n\t    <jats:title>Intervention:<\/jats:title>\n\t    <jats:p>The electronic health system software was modified to provide a best-practice advisory (BPA) prompt to the pharmacist upon order verification of vancomycin for patients with suspected or confirmed respiratory indications. Pharmacists were prompted to order a MRSA nasal swab if it was not already ordered by the provider.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2732494X22000146_as6\">\n\t    <jats:title>Methods:<\/jats:title>\n\t    <jats:p>We reviewed patient records to determine the time from vancomycin prescription to de-escalation. The secondary end point was incidence of acute kidney injury.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2732494X22000146_as7\">\n\t    <jats:title>Results:<\/jats:title>\n\t    <jats:p>The study included 120 patients (preimplementation, n = 61; postimplementation, n = 59). Median time to de-escalation was significantly shorter for the postimplementation cohort: 76 hours (interquartile range [IQR], 52\u2013109) versus 42 hours (IQR, 37\u201361; <jats:italic>P<\/jats:italic> = .002). Acute kidney injury occurred in 11 patients (18%) in the preimplementation cohort and in 3 patients (5%) in the postimplementation cohort (<jats:italic>P<\/jats:italic> = .01; number needed to treat, 8).<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2732494X22000146_as8\">\n\t    <jats:title>Conclusions:<\/jats:title>\n\t    <jats:p>Implementation of a BPA notification for MRSA nasal screening helped decrease the time to de-escalation of vancomycin.<\/jats:p>\n\t  <\/jats:sec>","DOI":"10.1017\/ash.2022.14","type":"journal-article","created":{"date-parts":[[2022,3,10]],"date-time":"2022-03-10T10:04:44Z","timestamp":1646906684000},"source":"Crossref","is-referenced-by-count":2,"title":["Effectiveness of an electronic health system\u2212based best-practice advisory to enhance the time to de-escalation of vancomycin for respiratory indications"],"prefix":"10.1017","volume":"2","author":[{"given":"Amanda C.","family":"Gibbs","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel A.","family":"Jackson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Senka","family":"Runjaic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanessa J.","family":"Toncray","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3021-2752","authenticated-orcid":false,"given":"Wendelyn","family":"Bosch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julio C.","family":"Mendez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2780-233X","authenticated-orcid":false,"given":"Kevin L.","family":"Epps","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2022,3,10]]},"reference":[{"key":"S2732494X22000146_ref12","doi-asserted-by":"publisher","DOI":"10.1136\/bmjqs-2015-004411"},{"key":"S2732494X22000146_ref9","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.01746-07"},{"key":"S2732494X22000146_ref10","doi-asserted-by":"publisher","DOI":"10.4037\/ajcc2015102"},{"key":"S2732494X22000146_ref13","doi-asserted-by":"publisher","DOI":"10.1186\/cc2872"},{"key":"S2732494X22000146_ref8","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciy024"},{"key":"S2732494X22000146_ref16","doi-asserted-by":"publisher","DOI":"10.2146\/ajhp160964"},{"key":"S2732494X22000146_ref2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw300"},{"key":"S2732494X22000146_ref3","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cis022"},{"key":"S2732494X22000146_ref14","doi-asserted-by":"publisher","DOI":"10.1345\/aph.1R370"},{"key":"S2732494X22000146_ref4","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw504"},{"key":"S2732494X22000146_ref5","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciq146"},{"key":"S2732494X22000146_ref15","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-13-268"},{"key":"S2732494X22000146_ref1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/civ629"},{"key":"S2732494X22000146_ref7","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01805-13"},{"key":"S2732494X22000146_ref6","doi-asserted-by":"publisher","DOI":"10.2146\/ajhp080434"},{"key":"S2732494X22000146_ref11","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01590-09"}],"container-title":["Antimicrobial Stewardship and Healthcare Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S2732494X22000146","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,3,10]],"date-time":"2022-03-10T10:04:48Z","timestamp":1646906688000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S2732494X22000146\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022]]},"references-count":16,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022]]}},"alternative-id":["S2732494X22000146"],"URL":"https:\/\/doi.org\/10.1017\/ash.2022.14","relation":{},"ISSN":["2732-494X"],"issn-type":[{"value":"2732-494X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022]]},"article-number":"e38"}}