Pyrogenic Reactions Associated With Single Daily Dosing of Intravenous Gentamicin

2000 ◽  
Vol 21 (12) ◽  
pp. 771-774 ◽  
Author(s):  
Udo Buchholz ◽  
Chesley Richards ◽  
Rekha Murthy ◽  
Matthew Arduino ◽  
Doreen Pon ◽  
...  
Keyword(s):  
Los Angeles ◽  
Community Hospital ◽  
Practice Change ◽  
Limulus Amebocyte Lysate ◽  
Factors Associated ◽  
Epidemic Period ◽  
Dosing Intervals ◽  
Parenteral Products ◽  
Clinical Practice Change ◽  
Limulus Amebocyte Lysate Assay

Objective:To identify risk factors associated with an unexpected outbreak of pyrogenic reactions (PR) following intravenous gentamicin.Design:We conducted two cohort studies. PRs were defined as chills, rigors, or shaking within 3 hours after initiating the gentamicin infusion during the preepidemic (December 1, 1997-January 15,1998) or epidemic (May 1-June 15,1998) periods. We tested gentamicin vials for endotoxin using the limulus amebocyte lysate assay.Setting:Inpatient services of a large community hospital in Los Angeles, California.Results:During the epidemic period, 22 (15%) of 152 patients developed documented PRs following intravenous gentamicin. PRs were more likely among patients receiving single daily dosing (SDD) than multiple daily dosing gentamicin (20/73 [27%] vs 2/79 [3%]; relative risk, 10.8; 95% confidence interval, 2.644.7). Laboratory analysis of gentamicin vials found endotoxin levels that were higher among Fujisawa-brand gentamicin (implicated brand) than gentamicin used after the outbreak terminated (non-implicated brand). Although endotoxin levels in the vials did not exceed US Pharmacopeia limits (1.7 endotoxin units/mg gentamicin), the use of SDD gentamicin may place patients at greater risk of receiving doses of endotoxin above the threshold for PRs in humans.Conclusions:Reassessment of the acceptable amounts of endotoxin in gentamicin and other parenteral products should be considered when dosing intervals used in clinical practice change.

scholarly journals Seroprevalence of antibodies to SARS-CoV-2 in healthcare workers: a cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e043584 ◽  
Author(s):  
Joseph E Ebinger ◽  
Gregory J Botwin ◽  
Christine M Albert ◽  
Mona Alotaibi ◽  
Moshe Arditi ◽  
...  
Keyword(s):  
African American ◽  
Los Angeles ◽  
Delivery System ◽  
Healthcare Workers ◽  
Los Angeles County ◽  
Healthcare Delivery ◽  
Healthcare Delivery System ◽  
Hispanic Ethnicity ◽  
Factors Associated ◽  
African American Race

ObjectiveWe sought to determine the extent of SARS-CoV-2 seroprevalence and the factors associated with seroprevalence across a diverse cohort of healthcare workers.DesignObservational cohort study of healthcare workers, including SARS-CoV-2 serology testing and participant questionnaires.SettingsA multisite healthcare delivery system located in Los Angeles County.ParticipantsA diverse and unselected population of adults (n=6062) employed in a multisite healthcare delivery system located in Los Angeles County, including individuals with direct patient contact and others with non-patient-oriented work functions.Main outcomesUsing Bayesian and multivariate analyses, we estimated seroprevalence and factors associated with seropositivity and antibody levels, including pre-existing demographic and clinical characteristics; potential COVID-19 illness-related exposures; and symptoms consistent with COVID-19 infection.ResultsWe observed a seroprevalence rate of 4.1%, with anosmia as the most prominently associated self-reported symptom (OR 11.04, p<0.001) in addition to fever (OR 2.02, p=0.002) and myalgias (OR 1.65, p=0.035). After adjusting for potential confounders, seroprevalence was also associated with Hispanic ethnicity (OR 1.98, p=0.001) and African-American race (OR 2.02, p=0.027) as well as contact with a COVID-19-diagnosed individual in the household (OR 5.73, p<0.001) or clinical work setting (OR 1.76, p=0.002). Importantly, African-American race and Hispanic ethnicity were associated with antibody positivity even after adjusting for personal COVID-19 diagnosis status, suggesting the contribution of unmeasured structural or societal factors.Conclusion and relevanceThe demographic factors associated with SARS-CoV-2 seroprevalence among our healthcare workers underscore the importance of exposure sources beyond the workplace. The size and diversity of our study population, combined with robust survey and modelling techniques, provide a vibrant picture of the demographic factors, exposures and symptoms that can identify individuals with susceptibility as well as potential to mount an immune response to COVID-19.

scholarly journals Valuing variance: the importance of variance analysis in clinical pathways utilisation

2007 ◽  
Vol 31 (4) ◽  
pp. 565 ◽  
Author(s):  
Kate L Hyett ◽  
Mike Podosky ◽  
Nick Santamaria ◽  
Jenni C Ham
Keyword(s):  
Health Care ◽  
Clinical Practice ◽  
Clinical Pathways ◽  
Service Planning ◽  
Practice Change ◽  
Variance Analysis ◽  
Analysis Software ◽  
Health Service Planning ◽  
Management Techniques ◽  
Clinical Practice Change

Variations from the anticipated course of events in clinical pathways provide valuable information that could be used to improve clinical practice and health service planning. Surprisingly, variance data are rarely collected in health care organisations using clinical pathways. This paper describes a project which aimed to improve reporting and analysis of variance data in a large regional and a smaller rural hospital using clinical pathways for a number of surgical, medical and obstetric procedures. The project used change management techniques and a variance analysis software program to inform clinical practice change.

scholarly journals PMC12 MODELLING THE VALUE FOR MONEY OF CLINICAL PRACTICE CHANGE: A STOCHASTIC APPLICATION IN DIABETES CARE

2008 ◽  
Vol 11 (6) ◽  
pp. A562-A563
Author(s):  
T Hoomans ◽  
K Abrams ◽  
SMAA Evers ◽  
AJHA Ament ◽  
JL Severens
Keyword(s):  
Clinical Practice ◽  
Diabetes Care ◽  
Practice Change ◽  
Value For Money ◽  
Clinical Practice Change

Identifying Risk Factors Associated With Inappropriate Use of Acid-Suppressive Therapy at a Community Hospital

2014 ◽  
Vol 109 ◽  
pp. S661-S662
Author(s):  
Amandeep Singh ◽  
Yvette Wang ◽  
Yinghui Lu ◽  
Alexandra Hanlon ◽  
Michael Davis
Keyword(s):  
Risk Factors ◽  
Community Hospital ◽  
Suppressive Therapy ◽  
Factors Associated ◽  
Inappropriate Use
Sign in / Sign up

Export Citation Format

Share Document