Swab Testing to Optimize Pneumonia Treatment With Empiric Vancomycin
This is a single center, pragmatic, randomized clinical trial (pRCT) examining whether reporting the results of a negative rapid PCR back to the provider via a pager alert results in decreased vancomycin utilization for critically ill adults with community-acquired pneumonia when compared with usual care.
- EligibilityCriteria: Inclusion Criteria:  Adult (age greater than or equal to 18) patients admitted/transferred to the Vanderbilt University Medical Center (VUMC) Medical Intensive Care Unit (MICU) from the VUMC Emergency Department or from a hospital floor within 48 hours of admission. Suspicion for pneumonia on admission (defined as an indication for antibiotics of "respiratory infection" and/or an order for a respiratory culture i.e., sputum culture, tracheal aspirate culture, or bronchoalveolar lavage (BAL) culture). No topical nasal decolonization during hospitalization prior to collection of MRSA nasal swab PCR.  Must match both of the following in either order:  The patient has been admitted to and physically located in the MICU. The patient has received a continuing vancomycin order, or a pharmacokinetics consult for a continuing vancomycin order, no later than 24 hours following their physical admission to the MICU.  Exclusion Criteria:  Hospital stay of longer than 48 hours prior to MICU admission. Known to be a prisoner - HealthyVolunteers: No - Gender: All - MinimumAge: 18 Years - StdAgeList: Adult, Older Adult