Archive for May 2011

Patient mobile phones carry bugs

This cross sectional study found that 40% of patient and visitors mobile phones were colonized with multi-drug resistant organisms. This may be an unexpected and difficult to eradicate source of patient infections (abstract)

Fidaxomicin approved for Cdiff treatment

Dificid (fidaxomicin) was approved by the FDA for treatment of Cdiff. In randomized trials, it was found to have similar efficacy to vancomycin, but with fewer relapses. However, due to high cost, it may be best reserved for treatment relapses after metronidazole and/or vancomycin failures (FDA site)

Bacterial meningitis in the US

From a large national database, researchers determined the incidence of bacterial meningitis significantly decreased from 1998 to 2007 by 31%, but the case fatality rate remained essential unchanged (at around 15%). Continued efforts for early and appropriate antibiotics should continue (abstract)

Echo inaccurate for estimating pulmonary HTN

In this single center cohort of 160 patients with pulmonary HTN who underwent both echo and right heart cath, echo was inaccurate by at least 10mmHg in half of the patients (about half were overestimates and half underestimates). Echo should not be routinely used to diagnose, or follow efficacy of therapy, in pulmonary HTN (abstract)

Do We Have Any Clue How To Cut The Cost Of Healthcare?

At the Society of Hospital Medicine’s annual meeting last week in Dallas, Lenny Feldman of Johns Hopkins presented the results of a neat little study. His hypothesis: physicians given information about the costs of their laboratory tests would order fewer of them. Feldman randomized 62 tests either to be displayed per usual on the computerized order entry screen or to have the cost of the test appear next to the test’s name. Some of these were relatively inexpensive and frequently performed tests. After randomization, for example, the costs of hemoglobins ($3.46) and comprehensive metabolic panels ($15.44) were displayed, while TSHs ($24.53) and blood gases ($28.25) were not. He also randomized more expensive tests: the costs of BNPs ($49.56) were displayed, while hepatitis C genotypes ($238.62) were not. The educational intervention was surprisingly powerful. Over the six-month study, the aggregate expenditures for each test whose costs were displayed went down by…