More careful use of antibiotics at hospital discharge can help slow the emergence and spread of antibiotic resistance, according to AHRQ-supported research published in Clinical Infectious Diseases. Study authors built a risk-adjusted predictive model for post-discharge length of antibiotic therapy to measure how often and for how long hospitals prescribe antibiotics at discharge. Their review of 1.8 million hospital stays across 129 Veterans Health Administration hospitals from 2018 to 2021 showed that 1 in 5 patients (19.5 percent) received antibiotics at discharge, usually for about seven days. Using the model to compare hospitals, they found 30 percent of hospitals gave fewer antibiotics and shorter treatments than expected; however, 22 percent of hospitals gave antibiotics more often and for longer than needed, suggesting this metric may help hospitals identify opportunities for improved antibiotic stewardship at discharge. Access the abstract.

AHRQ is seeking acute care hospitals to join a free 9-month program beginning in July to implement strategies to reduce central line-associated bloodstream infections. Participants will receive free expert consultation to promote infection prevention procedures, regular benchmarking reports, guidance on enhancing teamwork and continued education credits. Apply now or register for one of several informational webinars.

An AHRQ-supported study identified 12 technological barriers affecting pediatric mental and behavioral healthcare in pediatric and adult emergency departments. The research published in Applied Ergonomics identified limitations in electronic medical records management, ineffective communication systems in the emergency department, infrastructure inadequacies and insufficient tools for patient engagement among challenges that impact the quality and safety of care. Researchers concluded future research should focus on the barriers while aiming to create design solutions that assist clinicians in their caregiving roles for pediatric mental and behavioral healthcare, focusing on patient safety. Access the abstract.

Significant shortcomings in electronic health records (EHRs) used by primary care practices hinder the delivery of evidence-based care for alcohol use disorders (AUD) and unhealthy alcohol use, according to an AHRQ-funded study published in JAMIA Open. An evaluation of 21 EHR systems across 167 practices in seven states found that only 3 percent of practices could generate reports on preventive measures like brief interventions, and just 7 percent could report on treatment initiation and engagement for AUD. These findings highlight critical barriers that limit the ability of primary care providers to address a major public health issue, with alcohol use contributing to over 140,000 U.S. deaths annually. The study emphasizes the need for systemic improvements in EHR functionality to enhance alcohol-related care and offers actionable insights for policymakers, technology developers and healthcare providers. Access the abstract.

An AHRQ-funded study has found that penicillin may be an effective treatment for a small but significant portion of community-acquired skin and soft tissue infections in children caused by methicillin-susceptible strains of Staphylococcus aureus (MSSA). Although penicillin-resistant strains comprised the majority of the infections found in a surveillance study conducted at Texas Children’s Hospital, researchers discovered that 9 percent of infections caused by MSSA could be treated with penicillin. Infections caused by penicillin-susceptible MSSA were associated with higher rates of hospital admission and surgical intervention than those caused by penicillin-resistant strains, highlighting their clinical importance. These findings suggested that it may be time to reconsider penicillin susceptibility testing and treatment options for S. aureus infections in the outpatient setting, particularly as most skin infections are managed outside hospitals. This shift could improve care and reduce reliance on other antibiotics. Access the abstract, in Microbiology Spectrum.