Hospital Medicine Alert – March 1, 2017

March 1, 2017

• Discharge Antibiotic Prescriptions Often Are Inappropriate with Regard to Choice, Dose, Duration

  SYNOPSIS: Seventy percent of discharge antibiotic prescriptions are inappropriate.

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• Antibiotic Treatment in Community-acquired Pneumonia

  SYNOPSIS: In patients with newly diagnosed community-acquired pneumonia, basing the duration of antibiotic treatment on clinical stability criteria led to a significant reduction in duration of antibiotic treatment without an increased risk of adverse outcomes.

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• A New Risk Score for Stroke in Atrial Fibrillation

  SYNOPSIS: A new, simpler score for stroke risk prediction in atrial fibrillation patients uses biomarkers to supplant many clinical variables and outperforms the CHA₂DS₂-VASc score in two large cohorts.

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• NOACs in Patients Requiring Anticoagulation Post-PCI

  SYNOPSIS: The PIONEER study of atrial fibrillation patients post-percutaneous coronary intervention showed that regimens of clopidogrel plus reduced-dose regimens of rivaroxaban demonstrated lower bleeding and similar rates of stroke and adverse cardiac events compared with traditional warfarin triple therapy.

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• Troponin Highly Prognostic in Decompensated Heart Failure with Preserved Ejection Fraction

  SYNOPSIS: Among patients with acute decompensated heart failure and preserved ejection fraction, elevated troponin is associated with worse in-hospital outcomes and long-term survival, independent of other predictors.

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