Dizziness and the Otolaryngology Point of View
Dizziness can be due to pathology from multiple physiologic systems, the most common being vestibular. Dizziness may be categorized as vertigo, disequilibrium, lightheadedness, or oscillopsia. Vertigo is an illusion of motion often caused by asymmetrical vestibular input to the brainstem. To evaluate vertigo, it is essential to include the symptom ’s quality, timing, frequency, trigger, influence from positional changes, and other associations from the history. Oculomotor, otologic, balance testing, positional testing, and nystagmus testing are equally important components of the examination. Two of the most common d...
Source: Medical Clinics of North America - September 20, 2018 Category: Primary Care Authors: Sharmeen Sorathia, Yuri Agrawal, Michael C. Schubert Source Type: research

Chronic Ear Disease
Chronic ear disease is composed of a spectrum of otologic disorders intrinsically tied to Eustachian tube dysfunction. Presentation can range from asymptomatic findings on physical examination to critically ill patients with intracranial complications. Internists represent the first line in diagnosis of these conditions, making awareness of the common signs and symptoms essential. With surgical management often required, partnership between internal medicine and otolaryngology is fundamental in the management of patients with chronic ear disease. (Source: Medical Clinics of North America)
Source: Medical Clinics of North America - September 20, 2018 Category: Primary Care Authors: Susan D. Emmett, John Kokesh, David Kaylie Source Type: research

Head and Neck Manifestations of Systemic  Disease
Systemic diseases commonly managed by the Internist may have presentations within the head and neck. Awareness of these manifestations, sometimes as the presenting signs or symptoms of systemic disease, may aid the Internist in diagnosis and management. The Otolaryngologist may be helpful in assisting in the evaluation of these patients and in some cases providing targeted symptomatic therapy. Some systemic processes can generate emergent airway events, and early engagement of the otolaryngologist is of value. (Source: Medical Clinics of North America)
Source: Medical Clinics of North America - September 20, 2018 Category: Primary Care Authors: Annie E. Moroco, Johnathan D. McGinn Source Type: research

Speech Language Pathology Rehabilitation
This article summarizes the variety of speech and swallow rehabilitation that adult patients may require or seek. The case examples allow the reader to base the clinical decision-making process within the context of a patient presentation and elucidate the role of speech and language pathology services for the primary care provider in order to refer patients with symptoms and concerns to the right provider early in their medical care. (Source: Medical Clinics of North America)
Source: Medical Clinics of North America - September 20, 2018 Category: Primary Care Authors: Kristine Pietsch, Tiffany Lyon, Vaninder K. Dhillon Source Type: research

Facial Nerve Paralysis
Patients afflicted with facial paralysis suffer significant physical and psychosocial effects that can lead to depression and social isolation. Timely diagnosis and initiation of appropriate therapy are keys to achieving good outcomes in the management of facial paralysis. Eye protection is of paramount importance to prevent vision loss in patients with impaired eye closure. Patients should be assessed for signs of depression and treated appropriately. (Source: Medical Clinics of North America)
Source: Medical Clinics of North America - September 20, 2018 Category: Primary Care Authors: James A. Owusu, Charles Stewart, Kofi Boahene Source Type: research

Head and Neck Masses
Head and neck cancers comprise 4% of the cancer burden in the United States each year. Many types of head and neck cancers present as an asymptomatic, nontender neck mass or nonspecific symptoms, such as hoarseness, sore throat, and pain. Head and neck cancers are frequently diagnosed incidentally by the primary care physician or dentist. This review summarizes the epidemiology, clinical manifestations, diagnosis, and treatment of several common head and neck cancers in order to provide an increased awareness for the internist to facilitate early detection of these diseases. (Source: Medical Clinics of North America)
Source: Medical Clinics of North America - September 20, 2018 Category: Primary Care Authors: Kenneth Yan, Nishant Agrawal, Zhen Gooi Source Type: research

Urgent Infections of the Head and Neck
This article provides a review of these conditions, including the pathophysiology, presenting features, and initial management strategy. (Source: Medical Clinics of North America)
Source: Medical Clinics of North America - September 20, 2018 Category: Primary Care Authors: Marika D. Russell, Matthew S. Russell Source Type: research

Otolaryngology for the Internist
The practice of Otolaryngology involves both the medical and surgical management of disorders and diseases of the head and neck. The anatomy and function of the otolaryngology, head and neck surgeon span a wide array of cranial nerves and structures that include the special senses of olfaction, gustation, hearing, balance, and the sense of touch as well as the vital functions of breathing, chewing, swallowing, and talking. This expertise includes the nose and sinuses (rhinology); specialized care of the pediatric population; the ear, hearing, and balance (otology and neurotology); the throat, including voice and swallowing...
Source: Medical Clinics of North America - September 20, 2018 Category: Primary Care Authors: C. Matthew Stewart Tags: Preface Source Type: research

Reflections
Along with the stethoscope, the head mirror has historically been one of the most recognizable devices used to depict physicians. This simple tool, consisting of a concave mirror with a small hole in the middle attached to a headband, has been a cornerstone of examination of the ear, nose, and throat. When a light source is directed at the mirror, the reflection serves to illuminate a concentrated area and enhance direct visualization. Similar to the stethoscope, its accepted use can be traced back to the 1800s. (Source: Medical Clinics of North America)
Source: Medical Clinics of North America - September 20, 2018 Category: Primary Care Authors: Bimal H. Ashar Tags: Foreword Source Type: research

Update on Management of Hoarseness
This article uses the broader term dysphonia because it reflects of a wide range of voice complaints, with or without vocal roughness. Dysphonia is often caused by benign conditions but may also be the sentinel symptom of a serious or progressive condition requiring immediate diagnosis and management. The role of laryngeal visualization in assessment and diagnosis for these patients is critical. (Source: Medical Clinics of North America)
Source: Medical Clinics of North America - September 11, 2018 Category: Primary Care Authors: Sandra Stinnett, Monika Chmielewska, Lee M. Akst Source Type: research

The Aging Face
The aging face is a popular topic in modern medicine. To understand and treat unwanted signs of aging, it is imperative to understand the biological and physical causes and contributing factors to facial aging, preventative measures to avoid advanced facial aging, and current treatment options. Changes to the human face are progressive with time; however, there are many methods, both surgical and nonsurgical, to reduce the stigmata of aging and provide patients with the appearance they desire. The process of aging is discussed in this article, as well as the multiple treatment options, both surgical and nonsurgical. (Sourc...
Source: Medical Clinics of North America - September 11, 2018 Category: Primary Care Authors: Anil R. Shah, Paige M. Kennedy Source Type: research

Antibiotic Stewardship
Empiric therapy of the septic patient in the hospital is challenging. Antibiotic stewardship is concerned with optimizing antibiotic use and minimizing resistance. Clinicians should avoid overcovering and overtreating colonizing organisms in respiratory secretions and urinary catheters. Empiric therapy should take into account the prevalence of multidrug-resistant organisms in the hospital setting. The most effective resistance prevention strategies is to preferentially select a low resistance potential antibiotic, which should be administered in the highest possible dose without toxicity for the shortest duration to elimi...
Source: Medical Clinics of North America - August 18, 2018 Category: Primary Care Authors: Cheston B. Cunha, Steven M. Opal Source Type: research

Creative Collaborations in Antimicrobial Stewardship
Antimicrobial stewardship program (ASP) success and growth rely on recurring collaborations with partners within the health care system, such as administration, clinical services, infection prevention, pharmacy, the medical school, and microbiology. These collaborations present valuable opportunities for development of hospital policies, institutional guidelines, and educational curriculum. External opportunities for collaboration may be less frequent but equally valuable. These collaborations are facilitated by health system partnerships with national quality organizations, neighboring ASPs, and the Department of Health. ...
Source: Medical Clinics of North America - August 18, 2018 Category: Primary Care Authors: Priya Nori, Yi Guo, Belinda Ostrowsky Source Type: research

The Role of the Hospital Epidemiologist in Antibiotic Stewardship
Antibiotic stewardship programs (ASPs) play a crucial role in controlling the emergence of resistant organisms, reducing rates of Clostridium difficile infections and associated hospital length of stay, promoting judicious use of antibiotics, and minimizing associated adverse events. There is a significant overlap between the goals of infection control programs and ASPs, and both programs can benefit from a synergistic relationship. Hospital epidemiologists can support these programs by providing leadership support, sharing surveillance data, bridging gaps between ASPs and departments such as microbiology, integrating educ...
Source: Medical Clinics of North America - August 18, 2018 Category: Primary Care Authors: Salma Abbas, Michael P. Stevens Source Type: research

Antimicrobial Stewardship in Community Hospitals
Antibiotic stewardship programs are needed in all health care facilities, regardless of size and location. Community hospitals that have fewer resources may have different priorities and require different strategies when defining antibiotic stewardship program components and implementing interventions. By following the Centers for Disease Control and Prevention Core Elements and using the strategies suggested in this article, readers should be able to design, develop, participate in, or improve antibiotic stewardship programs within community hospitals. (Source: Medical Clinics of North America)
Source: Medical Clinics of North America - August 18, 2018 Category: Primary Care Authors: Whitney R. Buckel, John J. Veillette, Todd J. Vento, Edward Stenehjem Source Type: research

Role of the Pharmacist in Antimicrobial Stewardship
The goals of antimicrobial stewardship are to optimize antimicrobial use to improve patient outcomes and minimize adverse consequences. A successful antimicrobial stewardship program is one that is multidisciplinary. Pharmacists are core members of antimicrobial stewardship and undertake multiple roles to accomplish the goals of the program. As antimicrobial stewardship continues to expand across the patient care continuum, pharmacists will serve a vital role in preserving the armamentarium of antimicrobials and improving quality of patient care. (Source: Medical Clinics of North America)
Source: Medical Clinics of North America - August 18, 2018 Category: Primary Care Authors: Diane M. Parente, Jacob Morton Source Type: research

Role of Education in Antimicrobial Stewardship
The ability to treat infectious diseases with antimicrobials is an essential component of medical management. Antimicrobial therapy is based on the characteristics of the patient, drug, microorganisms causing the infection, and colonizing flora. Prudent antibiotic use is the only option to delay the emergence of resistance. Training in infectious diseases and knowledge of the principles of responsible antibiotic prescribing and uses must be improved. To change practice, health care professionals should be educated at all levels of their training. (Source: Medical Clinics of North America)
Source: Medical Clinics of North America - August 18, 2018 Category: Primary Care Authors: Inge C. Gyssens Source Type: research

Antimicrobial Stewardship
MEDICAL CLINICS OF NORTH AMERICA (Source: Medical Clinics of North America)
Source: Medical Clinics of North America - August 18, 2018 Category: Primary Care Authors: Cheston B. Cunha Source Type: research

Copyright
ELSEVIER (Source: Medical Clinics of North America)
Source: Medical Clinics of North America - August 18, 2018 Category: Primary Care Source Type: research

Forthcoming Issues
Otolaryngology (Source: Medical Clinics of North America)
Source: Medical Clinics of North America - August 18, 2018 Category: Primary Care Source Type: research

Contributors
BIMAL H. ASHAR, MD, MBA, FACP (Source: Medical Clinics of North America)
Source: Medical Clinics of North America - August 18, 2018 Category: Primary Care Source Type: research

Contents
Erratumxvii (Source: Medical Clinics of North America)
Source: Medical Clinics of North America - August 18, 2018 Category: Primary Care Source Type: research

Erratum
In the July 2018 issue of Medical Clinics (Volume 102, Issue 4), the affiliations for Patrick  G. O’Connor and Michael D. Stein are listed incorrectly. The affiliations for both editors are: (Source: Medical Clinics of North America)
Source: Medical Clinics of North America - August 18, 2018 Category: Primary Care Source Type: research

CME Accreditation Page
(Source: Medical Clinics of North America)
Source: Medical Clinics of North America - August 18, 2018 Category: Primary Care Source Type: research

Sinuses and Common Rhinologic Conditions
This article is written with the intent to review these common rhinologic conditions for primary care providers and to summarize symptoms, diagnostic testing, differential diagnosis, and management/treatment approaches. (Source: Medical Clinics of North America)
Source: Medical Clinics of North America - August 18, 2018 Category: Primary Care Authors: Nyall R. London, Murugappan Ramanathan Source Type: research

Antimicrobial Stewardship and Antimicrobial Resistance
Antimicrobial stewardship programs aim to reduce costs, optimize therapeutic outcomes, and reduce antimicrobial resistance. Reductions of antimicrobial resistance are the most elusive because emergence and spread of resistant bacteria involves antimicrobial selective pressure and lapses in infection control techniques. The relationship between antimicrobial usage and resistance is not always direct. The understanding of which techniques are most effective is limited because many studies are descriptive or quasiexperimental. Recent meta-analyses or systematic reviews of stewardship programs offer encouragement that some int...
Source: Medical Clinics of North America - July 15, 2018 Category: Primary Care Authors: Louis B. Rice Source Type: research

Role of the Clinical Microbiology Laboratory in Antimicrobial Stewardship
For adequate antimicrobial stewardship, microbiology needs to move from the laboratory to become physically and verbally amenable to the caregivers of an institution. Herein, we describe the contributions of our microbiology department to the antimicrobial stewardship program of a large teaching hospital as 10 main points ranging from the selection of patients deemed likely to benefit from a fast track approach, to their clinical samples, or the rapid reporting of results via a microbiology hotline, to rapid searches for pathogens and susceptibility testing. These points should serve as guidelines for similar programs desi...
Source: Medical Clinics of North America - July 15, 2018 Category: Primary Care Authors: Emilio Bouza, Patricia Mu ñoz, Almudena Burillo Source Type: research

Current and Future Opportunities for Rapid Diagnostics in Antimicrobial Stewardship
Rapid diagnostic testing has improved clinical care of patients with infectious syndromes when combined with antimicrobial stewardship. The authors review the current data on antimicrobial stewardship and rapid diagnostic testing in bloodstream, respiratory tract, and gastrointestinal tract infections. Evidence for the potential benefit of rapid tests in bloodstream infections seems strong, respiratory tract infections mixed, and gastrointestinal tract infections still evolving. The authors also review future directions in rapid diagnostic testing and suggest areas of focus for antimicrobial stewardship efforts. (Source: M...
Source: Medical Clinics of North America - July 15, 2018 Category: Primary Care Authors: Tristan T. Timbrook, Emily S. Spivak, Kimberly E. Hanson Source Type: research

Role of Technology in Antimicrobial Stewardship
Because of the increasing plague of antimicrobial resistance and antibiotic misuse, antimicrobial stewardship programs (ASPs) are now a mandatory entity in all US hospitals. ASPs can use technological advances, such as the electronic medical record and clinical decision support systems, to impact a larger patient population with more efficiency. Additionally, through the use of mobile applications and social media, ASPs can highlight and propagate educational information regarding antimicrobial utilization to patients and providers in a widespread and timely manner. In this article, the authors describe how technology can ...
Source: Medical Clinics of North America - July 15, 2018 Category: Primary Care Authors: Derek N. Bremmer, Tamara L. Trienski, Thomas L. Walsh, Matthew A. Moffa Source Type: research

Metrics of Antimicrobial Stewardship Programs
This article reviews the various antimicrobial stewardship metrics that have been described in the literature, evidence to support these metrics, controversies surrounding metrics, and areas in which future research is necessary. (Source: Medical Clinics of North America)
Source: Medical Clinics of North America - July 15, 2018 Category: Primary Care Authors: Amy L. Brotherton Source Type: research

The Pharmacoeconomic Aspects of Antibiotic Stewardship Programs
Optimal antimicrobial therapy must take into account the key factors in antibiotic selection, that is, spectrum, tissue penetration, resistance potential, safety profile, and relative cost-effectiveness. The least expensive drug is usually accompanied by other concerns, such as high resistance potential, poor side effect profile, pharmacokinetic properties that limit penetration into target tissue (site of infection), and/or suboptimal activity against the presumed/known pathogen. It is false economy to preferentially select the least expensive antibiotics solely because of its acquisition cost. Therapeutic failure and hid...
Source: Medical Clinics of North America - July 15, 2018 Category: Primary Care Authors: Cheston B. Cunha Source Type: research

An Overview of Antimicrobial Stewardship Programs: Imperatives, Interventions, and Innovations
Antibiotic Stewardship or Antimicrobial Stewardship Programs (ASPs) are The Joint Commission (TJC) mandated to optimize antibiotic use in the hospital. Before ASPs were formally created, infectious disease (ID) clinicians were the stewards of antibiotic therapy. ID clinicians continue to be the leaders and advocates of optimal antibiotic use. Effective ASPs require a multidisciplinary coordinated approach led by a dynamic ID clinician team leader supported by a staff of ID-trained clinical PharmDs and IT personnel. (Source: Medical Clinics of North America)
Source: Medical Clinics of North America - July 15, 2018 Category: Primary Care Authors: Cheston B. Cunha Tags: Preface Source Type: research

Make Antibiotics Great Again
In 1909, German physician, Paul Ehrlich, discovered a chemical called arsphenamine that was found to be an effective treatment for syphilis.1 This became the first modern antibiotic, with penicillin being discovered about two decades later. Today, there are well over 100 different antibiotics on the market that are being prescribed for a multitude of different symptoms/infections. According to the Centers for Disease  Control and Prevention, there were approximately 269 million outpatient antibiotic prescriptions filled in 2015. (Source: Medical Clinics of North America)
Source: Medical Clinics of North America - June 27, 2018 Category: Primary Care Authors: Bimal H. Ashar Tags: Foreword Source Type: research

Antimicrobial Resistance
Antimicrobial resistance (AR) is one of the most serious public health threats today, which has been accelerated by the overuse and misuse of antimicrobials in humans and animals plus inadequate infection prevention. Numerous studies have shown a relationship between antimicrobial use and resistance. Antimicrobial stewardship (AS) programs have been shown to improve patient outcomes, reduce antimicrobial adverse events, and decrease AR. AS programs, when implemented alongside infection control measures, especially hand-hygiene interventions, were more effective than implementation of AS alone. Targeted coordination and pre...
Source: Medical Clinics of North America - June 26, 2018 Category: Primary Care Authors: Edward Joel Septimus Source Type: research

Nontraditional Alcohol and Opioid Agonist Treatment Interventions
This article reviews the available evidence of these treatment modalities. (Source: Medical Clinics of North America)
Source: Medical Clinics of North America - June 20, 2018 Category: Primary Care Authors: Christopher Fairgrieve, Nadia Fairbairn, Jeffrey H. Samet, Seonaid Nolan Source Type: research

Office-Based Addiction Treatment in Primary Care
Primary care is an important setting for delivering evidence-based treatment to address substance use disorders. To date, effective approaches to treat, care largely incorporate pharmacotherapy with counseling-based interventions and rely on multidisciplinary teams. There is strong support for primary care-based approaches to address alcohol and opioid use disorder with growing data focused on people living with human immunodeficiency virus and those experiencing incarceration. Future work should focus on the implementation of these effective approaches to decrease health disparities among people with substance use and to ...
Source: Medical Clinics of North America - June 20, 2018 Category: Primary Care Authors: E. Jennifer Edelman, Benjamin J. Oldfield, Jeanette M. Tetrault Source Type: research

When and How to Treat Possible Cannabis Use Disorder
This article reviews the current state of knowledge regarding effective treatments for cannabis use disorder. (Source: Medical Clinics of North America)
Source: Medical Clinics of North America - June 20, 2018 Category: Primary Care Authors: Annie L évesque, Bernard Le Foll Source Type: research

New and Emerging Illicit Psychoactive Substances
Several novel psychoactive substances have emerged in recent years. Users are typically young men who use other substances. In the category of stimulants, cathinones ( “bath salts”) have predominated and can lead to agitation, psychosis, hyperthermia, and death. Synthetic cannabinoids (“spice”) are more potent than marijuana and can lead to agitation, psychosis, seizures, and death. There are no rapid tests to identify these substances and general treatmen t includes benzodiazepines for agitation and supportive therapy. Many Synthetic opioids are potent analogues of fentanyl and carry a high risk of...
Source: Medical Clinics of North America - June 20, 2018 Category: Primary Care Authors: Ryan Graddy, Megan E. Buresh, Darius A. Rastegar Source Type: research

Pain and Addiction
The current opioid crisis highlights an urgent need for better paradigms for prevention and treatment of chronic pain and addiction. Although many approach this complex clinical condition with the question, “Is this pain or is this addiction?,” it is more than the sum of its parts. Chronic pain among those with dependence and addiction often evolves into a complex disabling condition with pain at multiple sites, psychosocial dysfunctions, medical and psychiatric disorders, polypharmacy, and polysub stance use, all interacting with each other in complex ways (multimorbidity). The authors offer an integrative the...
Source: Medical Clinics of North America - June 20, 2018 Category: Primary Care Authors: Ajay Manhapra, William C. Becker Source Type: research

Addressing Adolescents ’ and Young Adults’ Substance Use Disorders
Adolescents and young adults (AYAs) have unique needs and important biopsychosocial differences when compared with older adults who use substances. As their brains continue to develop, youth are especially susceptible to the reinforcing effects of substances in the context of a still-developing capacity for executive control and decision making. In this article, the authors highlight key differences in the neurobiologic, epidemiologic, and relational aspects of substance use found in AYA. They also discuss how best to engage with youth who use substances and how prevention and intervention can be adapted for optimal effect...
Source: Medical Clinics of North America - June 20, 2018 Category: Primary Care Authors: Nicholas Chadi, Sarah M. Bagley, Scott E. Hadland Source Type: research

Inpatient Addiction Consult Service
Substance use disorders are highly prevalent and are a large driver of costly inpatient medical care; however, historically the substance use disorder has gone unaddressed during an inpatient stay. Inpatient addiction consult services are an important intervention to use the reachable moment of hospitalization to engage patients and initiate addiction treatment. Addiction consultation involves taking an addiction-specific history, motivational interviewing, withdrawal symptom management, and initiation of long-term pharmacotherapy. Addiction consult services have the potential to decrease readmissions and utilization costs...
Source: Medical Clinics of North America - June 20, 2018 Category: Primary Care Authors: Zoe M. Weinstein, Sarah E. Wakeman, Seonaid Nolan Source Type: research

Weighing the Risks and Benefits of Electronic Cigarette Use in High-Risk Populations
This article reviews the current evidence on electronic cigarette (e-cigarette) safety and efficacy for smoking cessation, with a focus on smokers with cardiovascular disease, pulmonary disease, or serious mental illness. In the United States, adult smokers use e-cigarettes primarily to quit or reduce cigarette smoking. An understanding of the potential risks and benefits of e-cigarette use may help clinicians counsel smokers about the potential impact of e-cigarettes on health. (Source: Medical Clinics of North America)
Source: Medical Clinics of North America - June 20, 2018 Category: Primary Care Authors: Deepa R. Camenga, Hilary A. Tindle Source Type: research

The Internist ’s Challenge: Addressing Our Patients’ Unhealthy Substance Use
The first two decades of the twenty-first century will be remembered as the time when the harm of illicit drug use, longstanding cause of substantial morbidity and mortality, gained the undivided attention of North Americans due to a devastating opioid crisis. Remarkably, the adverse consequences of opioids and other drugs are an almost-daily feature in the media as deaths from overdoses mount. At the same time, legal substances, alcohol and tobacco, continue to quietly but dreadfully leave even greater overall health consequences in their wake. (Source: Medical Clinics of North America)
Source: Medical Clinics of North America - June 20, 2018 Category: Primary Care Authors: Jeffrey H. Samet, Patrick G. O'Connor, Michael D. Stein Tags: Preface Source Type: research

CME Accreditation page
(Source: Medical Clinics of North America)
Source: Medical Clinics of North America - June 20, 2018 Category: Primary Care Source Type: research

Substance Use and Addiction Medicine
MEDICAL CLINICS OF NORTH AMERICA (Source: Medical Clinics of North America)
Source: Medical Clinics of North America - June 20, 2018 Category: Primary Care Authors: Jeffrey H. Samet, Patrick G. O'Connor, Michael D. Stein Source Type: research

Copyright
ELSEVIER (Source: Medical Clinics of North America)
Source: Medical Clinics of North America - June 20, 2018 Category: Primary Care Source Type: research

Forthcoming Issues
Antimicrobial Stewardship (Source: Medical Clinics of North America)
Source: Medical Clinics of North America - June 20, 2018 Category: Primary Care Source Type: research

Contributors
BIMAL H. ASHAR, MD, MBA, FACP (Source: Medical Clinics of North America)
Source: Medical Clinics of North America - June 20, 2018 Category: Primary Care Source Type: research

Contents
Bimal H. Ashar (Source: Medical Clinics of North America)
Source: Medical Clinics of North America - June 20, 2018 Category: Primary Care Source Type: research

Antimicrobial Stewardship Programs
Antimicrobial stewardship involves optimizing antibiotic use while using cost-effective interventions to minimize antibiotic resistance and control Clostridium difficile. An effective hospital-wide antimicrobial stewardship program (ASP) should be led by an infectious disease (ID) physician. The ASP team needs full and ongoing financial support for the ASP from the hospital administration. The ID clinician leader should have special expertise in various aspects of antimicrobial therapy, that is, pharmacokinetics, resistance, pharmacoeconomics, and C difficile. The ASP ID team leader and ID-trained clinical pharmacist staff...
Source: Medical Clinics of North America - June 14, 2018 Category: Primary Care Authors: Cheston B. Cunha Source Type: research