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 Case Study: Targeted Therapies Combine With Teamwork


Even in instances where an infection is potentially challenging and life-threatening, thoughtful and judicious use of antibiotics and collaborative partnerships among staff can save a life and lead to better care.

James Gonzalez, MPH, FACHE, LNHA, president and chief executive officer of Broadway House for Continuing Care in Newark, N.J., recalls the time a resident had acquired a fungal infection following an orthopedic surgical procedure.

“What was unique about this case was his infection was not from the surgery, but from his drug addiction. He was shooting heroin in one of the veins in his neck, and that became a very challenging infection.”

The location of the infection was particularly dangerous, as it had the potential to impact neurological function and lead to other adverse physiological reactions.

Treating the patient required some intensive monitoring, taking cultures every seven to 10 days, and trying to give the minimal amount of antibiotics.

“We started with a lower intensity, rather than going up to the highest intensity,” he says. The consulting pharmacist worked in conjunction with the center’s infectious disease specialists and nurses to monitor this particular patient, whose infection resolved within three to four weeks.

This case underscores the fact that stewardship takes a team effort: understanding what the infection is and the impact of the antibiotic that’s being used, Gonzalez says, and, finally, continuously monitoring blood cultures.
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