Oritavancin as sequential therapy for Gram-positive bloodstream infections.

BACKGROUND: Oritavancin, a long-acting lipoglycopeptide approved for use in acute bacterial skin and skin structure infections, has limited data evaluating use in serious infections due to Gram-positive organisms. We aimed to assess the effectiveness and safety of oritavancin for consolidative treatment of Gram-positive bloodstream infections (BSI), including infective endocarditis (IE). METHODS: We conducted a retrospective cohort study evaluating adult patients admitted to University of Colorado Hospital from March 2016 to January 2022 who received ≥ 1 oritavancin dose for treatment of Gram-positive BSI. Patients were excluded if the index culture was drawn at an outside facility or were > 89 years of age. The primary outcome was a 90-day composite failure (clinical or microbiological failure) in those with 90-day follow-up. Secondary outcomes included individual components of the primary outcome, acute kidney injury (AKI), infusion-related reactions (IRR), and institutional cost avoidance. RESULTS: Overall, 72 patients were included. Mean ± SD age was 54 ± 16 years, 61% were male, and 10% had IE. Organisms most commonly causing BSI were Staphylococcus aureus (68%, 17% methicillin-resistant), followed by Streptococcus spp. (26%), and Enterococcus spp. (10%). Patients received standard-of-care antibiotics before oritavancin for a median (IQR) of 11 (5-17) days. Composite failure in the clinically evaluable population (n = 64) at 90-days occurred in 14% and was composed of clinical and microbiological failure, which occurred in 14% and 5% of patients, respectively. Three patients (4%) experienced AKI after oritavancin, and two (3%) experienced an IRR. Oritavancin utilization resulted in earlier discharge for 94% of patients corresponding to an institutional cost-avoidance of $3,055,804 (mean $44,938/patient) from 1,102 hospital days saved (mean 16 days/patient). CONCLUSIONS: The use of oritavancin may be an effective sequential therapy for Gram-positive BSI to facilitate early discharge resulting in institutional cost avoidance.

Research productivity in select psychology journals, 1986-2008.

Examination of research productivity has a long history in psychology. Journals across psychology have periodically published research-productivity studies. An analysis of institutional research productivity was conducted for 17 journals published by the American Psychological Association for the years 1986-2008. This analysis implemented two methodologies: one a replication and extension of G. S. Howard, D. A. Cole, and S. E. Maxwell's (1987) method, the other a new method designed to give credit to psychology departments rather than only overall institutions. A system of proportional credit assured all articles with multiple institutions received credit. Results show that for the 23-year period, the University of Illinois at Urbana-Champaign was ranked 1st, followed by the University of California, Los Angeles, and the University of Michigan, Ann Arbor. Overall, results showed both consistency and change across all journals examined. The authors explore the implications of these findings in the context of the current academic environment.

The utility of the AUDIT in screening for drinking game involvement among female college students.

Drinking games (DG) facilitate heavy alcohol consumption in a short period and are associated with negative experiences. We examined the utility of Alcohol Use Disorders Identification Test (AUDIT) cut-off scores to identify DG involvement. Findings indicated an AUDIT score of at least 5 is needed to identify gamers among students at a women's college. Prevention implications are discussed.