Stanley L. Pestotnik

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OBJECTIVE To determine the excess length of stay, extra costs, and mortality attributable to adverse drug events (ADEs) in hospitalized patients. DESIGN Matched case-control study. SETTING The LDS Hospital, a tertiary care health care institution. PATIENTS All patients admitted to LDS Hospital from January 1, 1990, to December 31, 1993, were eligible.(More)
BACKGROUND AND METHODS Optimal decisions about the use of antibiotics and other antiinfective agents in critically ill patients require access to a large amount of complex information. We have developed a computerized decision-support program linked to computer-based patient records that can assist physicians in the use of antiinfective agents and improve(More)
BACKGROUND Randomized, controlled trials have shown that prophylactic antibiotics are effective in preventing surgical-wound infections. However, it is uncertain how the timing of antibiotic administration affects the risk of surgical-wound infection in actual clinical practice. METHODS We prospectively monitored the timing of antibiotic prophylaxis and(More)
Objective: To develop a new method to improve the detection and characterization of adverse drug events (ADEs) in hospital patients. Design: Prospective study of all patients admitted to our hospital over an 18 month period. Setting: LDS Hospital, Salt Lake City, Utah, a 520-bed tertiary care center affiliated with the University of Utah School of Medicine,(More)
OBJECTIVE To determine the clinical and financial outcomes of antibiotic practice guidelines implemented through computer-assisted decision support. DESIGN Descriptive epidemiologic study and financial analysis. SETTING 520-bed community teaching hospital in Salt Lake City, Utah. PATIENTS All 162 196 patients discharged from LDS Hospital between 1(More)
A prospective study was performed over a two-year period to determine whether computer-generated reminders of perioperative antibiotic use could improve prescribing habits and reduce postoperative wound infections. During the first year, baseline patterns of antibiotic use and postoperative infection rates were established. During the second year,(More)
Health care-associated infections (HAIs) are a leading cause of in-hospital mortality and adverse events such as antimicrobial resistance. These infections place tremendous burdens on the health care system and create situations for misuse of antimicrobial drugs. Recognition of these factors has led professional societies, clinicians, and hospitals to(More)
OBJECTIVE To develop computerized methods to monitor and recommend dosage changes for patients treated with excessive dosages of imipenem/cilastatin (I/C) and to determine the incidence of I/C-associated seizures in our patient population. DESIGN Prospective observational and interventional study of all patients admitted to LDS Hospital and treated with(More)
PURPOSE We sought to quantify the incidence of, define risk factors for, and examine the relation between renal functional impairment and treatment with conventional amphotericin B. SUBJECTS AND METHODS We performed a 9-year retrospective analysis of amphotericin B-associated nephrotoxicity in 494 adult inpatients who received > or = 2 doses of(More)
Adverse drug events (ADEs) are a serious health problem and are the leading adverse event experienced by hospitalized patients. Numerous hospitals have used different methods to improve the reporting of ADEs but few have undertaken studies aimed at the prevention of ADEs. We found that computerized ADE surveillance identified significantly more ADEs than(More)