{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T18:40:38Z","timestamp":1785436838408,"version":"3.56.0"},"reference-count":28,"publisher":"Cambridge University Press (CUP)","issue":"4","license":[{"start":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T00:00:00Z","timestamp":1773014400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S0899823X26104218_as1\">\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>Vancomycin overuse in pneumonia should be a key target for antimicrobial stewardship according to Centers for Disease Control and Prevention. High negative predictive value of nasal Methicillin Resistant Staphylococcus aureus (MRSA) polymerase chain reaction (PCR) (nMP) screening for pneumonia has been shown. We implemented informatics-based ASP intervention to reduce vancomycin use in pneumonia by 20% in 6 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X26104218_as2\">\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Quasi-experimental: Pre-intervention period (P1: 4\/1\/24\u20139\/30\/24) compared with post-intervention period (P2: 10\/15\/24\u20133\/15\/2025).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X26104218_as3\">\n                    <jats:title>Setting:<\/jats:title>\n                    <jats:p>Quality improvement (QI) initiative in a tertiary-care center in Upper Midwest.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X26104218_as4\">\n                    <jats:title>Patients:<\/jats:title>\n                    <jats:p>Hospitalized pneumonia patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X26104218_as5\">\n                    <jats:title>Interventions:<\/jats:title>\n                    <jats:p>Automated default nMP order was incorporated in pneumonia order-set in electronic medical record while ordering vancomycin for hospital acquired\/ventilator associated pneumonia, severe community acquired pneumonia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X26104218_as6\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Outcome measures declined significantly: Average vancomycin use density as reported with days of therapy (DOT)\/1,000 patient days decreased by 49.5% (from 72.2 DOT\/1,000 patient days in P1 to 36.3 DOT\/1,000 patient days in P2;\n                      <jats:italic>p<\/jats:italic>\n                      &lt; .0001). Average vancomycin drug inventory cost decreased by 50% (from 1,089.5 U.S. Dollars (USD)\/1,000 patient days in P1 to 546.3 USD\/1,000 patient days in P2;\n                      <jats:italic>p<\/jats:italic>\n                      &lt; .0001). All process measures showed significant changes: nMP ordering increased to 100% in P2 (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; .0001); proportion of pneumonia patients with negative PCR results with discontinuation of vancomycin within 48\u201372 hours increased to 71% (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; .0001) and time to vancomycin discontinuation declined by 46% (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; .001). Balancing measures (readmissions; nMP order-to-result time) remained unchanged.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X26104218_as7\">\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Informatics-based ASP intervention was transformative leading to significant decline in vancomycin utilization, considerable healthcare-cost savings and significant increase in nMP screening among pneumonia patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/ice.2026.10421","type":"journal-article","created":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T08:05:15Z","timestamp":1773043515000},"page":"334-341","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["Optimization of vancomycin use in hospitalized patients with pneumonia through implementation of informatics based antimicrobial stewardship program (ASP) intervention"],"prefix":"10.1017","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2698-4151","authenticated-orcid":false,"given":"Ashlesha","family":"Kaushik","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05ntqke24","id-type":"ROR","asserted-by":"publisher"}],"name":"UnityPoint Health and University of Iowa Carver College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6610-318X","authenticated-orcid":false,"given":"Brittany","family":"Esty","sequence":"additional","affiliation":[{"name":"Boston Children\u2019s Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-6389-9715","authenticated-orcid":false,"given":"Corey","family":"Thieman","sequence":"additional","affiliation":[{"name":"UnityPoint Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susannah","family":"Kisvarday","sequence":"additional","affiliation":[{"name":"Harvard Medical School"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bijay","family":"Acharya","sequence":"additional","affiliation":[{"name":"Harvard Medical School"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dionne","family":"Graham","sequence":"additional","affiliation":[{"name":"Boston Children\u2019s Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Padomek","sequence":"additional","affiliation":[{"name":"UnityPoint Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chakri","family":"Pureti","sequence":"additional","affiliation":[{"name":"UnityPoint Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandeep","family":"Gupta","sequence":"additional","affiliation":[{"name":"UnityPoint Health"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2026,3,9]]},"reference":[{"key":"S0899823X26104218_ref8","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw353"},{"key":"S0899823X26104218_ref10","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofaa538"},{"key":"S0899823X26104218_ref4","doi-asserted-by":"publisher","DOI":"10.1016\/j.infpip.2022.100254"},{"key":"S0899823X26104218_ref16","doi-asserted-by":"publisher","DOI":"10.29074\/ascls.27.1.13"},{"key":"S0899823X26104218_ref17","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofab099"},{"key":"S0899823X26104218_ref15","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciy024"},{"key":"S0899823X26104218_ref25","volume-title":"Leading Change","author":"Kotter","year":"2012"},{"key":"S0899823X26104218_ref5","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2021-052165"},{"key":"S0899823X26104218_ref6","first-page":"20","article-title":"The importance of an antimicrobial stewardship program","volume":"32","author":"Baroudi","year":"2015","journal-title":"Fed Pract"},{"key":"S0899823X26104218_ref7","unstructured":"7. 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Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}}]}}