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Nicole S. Harrington, PharmD, BCPS, AQ-ID
Clinical Pharmacy Specialist
Expertise & Research Interests
- Clinical Pharmacy
- Patient Outcomes
- Antimicrobials
- Antimicrobial Resistance
- Antimicrobial Stewardship
Education
- PGY-2 Infectious Diseases Residency, ASHP Accredited, Thomas Jefferson University Hospital
- PGY-1 Pharmacy Practice Residency, ASHP Accredited, Thomas Jefferson University Hospita
- PharmD, Pharmacy, University of the Sciences in Philadelphia
Nicole S. Harrington, PharmD, BCPS, AQ-ID
Clinical Pharmacy Specialist
Nicole Harrington, PharmD, BCPS AQ-ID, is a clinical pharmacy specialist at ChristianaCare. Harrington co-chairs the ChristianaCare Antimicrobial Stewardship Program, a multidisciplinary team committed to promoting appropriate use of antimicrobials, improving patient outcomes, reducing antimicrobial resistance, and minimizing unintended harm. Harrington works with key stakeholders across the health system to create policies, guidelines, and education to support caregivers in the practical applications of antimicrobial stewardship. Harrington is a recipient of the Pharmacist of the Year honor by the Delaware Society of Health-System Pharmacists and a recipient of the Preceptor of the Year honor by ChristianaCare.
Experience
Media Appearances
ChristianaCare Residents Pen the Must-Have Book in Emergency Room Care
2023-08-08 , ChristianaCare News
Nicole Harrington, PharmD, BCPS-AQ ID, Clinical pharmacy specialist in Infectious Diseases, has helped edit the guide for the past decade.
“I feel fortunate to be part of a project that has such a meaningful impact,” Harrington said.
“By reaching so many different people and supporting them in making good antibiotic choices, we help improve patient outcomes.”
“I feel fortunate to be part of a project that has such a meaningful impact,” Harrington said.
“By reaching so many different people and supporting them in making good antibiotic choices, we help improve patient outcomes.”
eBrightHealth leaders collaborate to improve Delaware health care
2019-06-10 , eBrightHealth
Reporting on inpatient efforts at Christiana Care was Nicole Harrington, Pharm. D., BCPS, a clinical pharmacy specialist, Infectious Disease. [...] “Overall, we were able to see a decrease in fluoroquinolone use on both of these patient care units,” said Harrington, adding that even before beginning the project Christiana Care was performing better than the national benchmarks given for antibiotic usage. One aspect of future education will deal with illnesses, such as colitis, that can mimic infectious diseases and do not warrant the use of antibiotics, she said.
Hospital system vaccinates nearly 8,000 staff in daylong flu shot blitz
2018-10-14 , NBC News
Making it easier to get the vaccine can help encourage vaccination. Nicole Harrington, a specialty pharmacist who got her vaccine at the event Thursday, said it worked for her.
“I walked right in,” said Harrington, who was especially keen to be vaccinated because she is pregnant.
“I walked right in,” said Harrington, who was especially keen to be vaccinated because she is pregnant.
Selected Papers and Publications
923. Providers’ Perception of CME Antimicrobial Stewardship Quizzes and Its Impact on Antibiotic Prescribing Practices
2022
Background
A statewide antimicrobial stewardship (AS) collaborative across 5 health systems was formed with the mission to share best antibiotic prescribing. Recognizing that education is an important pillar of AS intervention, the statewide collaborative implemented a monthly CME quiz focusing on a wide range of clinical infectious diseases and AS topics. These quizzes consisted of 5-10 case-based and clinical pearl questions with evidence-based answers focusing on the adult and pediatric patient populations. Participants were awarded one hour CME credit. After 3 years of distributing the quizzes, we sought to assess the providers’ perceptions of the CME quizzes and their impact on clinical practice.
Methods
A nine-question survey was emailed to providers, pharmacists, and nurses.
Background
A statewide antimicrobial stewardship (AS) collaborative across 5 health systems was formed with the mission to share best antibiotic prescribing. Recognizing that education is an important pillar of AS intervention, the statewide collaborative implemented a monthly CME quiz focusing on a wide range of clinical infectious diseases and AS topics. These quizzes consisted of 5-10 case-based and clinical pearl questions with evidence-based answers focusing on the adult and pediatric patient populations. Participants were awarded one hour CME credit. After 3 years of distributing the quizzes, we sought to assess the providers’ perceptions of the CME quizzes and their impact on clinical practice.
Methods
A nine-question survey was emailed to providers, pharmacists, and nurses.
1680. Evaluation of the Urinalysis Reflex to Culture Sensitivity and Impact on Antibiotic Utilization
2020
Background
In June of 2016 at ChristianaCare a urinalysis with reflex to culture (UARC) order set was made available, which allows for urine cultures to be performed automatically if pre-defined criteria for a positive urinalysis are met. The objective of this study was to evaluate the utility of the UARC as it relates to identifying a symptomatic urinary tract infection (UTI), as well as to describe the impact of UARC on antibiotic utilization.
Methods
A retrospective cohort study was performed including patients aged 18 to 89 ordered a UARC. Patients were excluded if they were currently pregnant, had an absolute neutrophil count of < 100 cells/mm3, were undergoing a urological procedure, or receiving antibiotics for another indication. The primary outcome of this study was to determine the utility of the UARC in identifying a symptomatic UTI, as determined by the Youden index.
Background
In June of 2016 at ChristianaCare a urinalysis with reflex to culture (UARC) order set was made available, which allows for urine cultures to be performed automatically if pre-defined criteria for a positive urinalysis are met. The objective of this study was to evaluate the utility of the UARC as it relates to identifying a symptomatic urinary tract infection (UTI), as well as to describe the impact of UARC on antibiotic utilization.
Methods
A retrospective cohort study was performed including patients aged 18 to 89 ordered a UARC. Patients were excluded if they were currently pregnant, had an absolute neutrophil count of < 100 cells/mm3, were undergoing a urological procedure, or receiving antibiotics for another indication. The primary outcome of this study was to determine the utility of the UARC in identifying a symptomatic UTI, as determined by the Youden index.
1114. Oral β-lactams for the Treatment of Escherichia coli Bacteremia Secondary to Complicated Urinary Tract Infections Including Pyelonephritis
2019
Background
Complicated urinary tract infections (cUTI) including pyelonephritis may result in bacteremia, increasing the rate of morbidity and mortality. The Infectious Diseases Society of America recommends a fluoroquinolone as empiric therapy or trimethoprim/sulfamethoxazole as definitive therapy for acute pyelonephritis (AP). Oral β-lactams (BL) are considered sub-optimal based on historical efficacy data with aminopenicillins and variable bioavailability. Increasing resistance and toxicity with preferred agents, justifies further evaluation of oral BL for E. coli bacteremia secondary to urinary source.
Background
Complicated urinary tract infections (cUTI) including pyelonephritis may result in bacteremia, increasing the rate of morbidity and mortality. The Infectious Diseases Society of America recommends a fluoroquinolone as empiric therapy or trimethoprim/sulfamethoxazole as definitive therapy for acute pyelonephritis (AP). Oral β-lactams (BL) are considered sub-optimal based on historical efficacy data with aminopenicillins and variable bioavailability. Increasing resistance and toxicity with preferred agents, justifies further evaluation of oral BL for E. coli bacteremia secondary to urinary source.
1111. Characterization of Antibiotic Ordering in Patients with Mental Status Changes and Presumed Urinary Tract Infection in Patients 65 and Older
2019
Background
Altered mental status (AMS) is the most common diagnosis among those 65 and older who present to the emergency department (ED). Urinary tract infections (UTIs) account for 15.5% of hospitalizations in this population. The purpose of this study was to determine the incidence of initiation of antibiotics in the ED in patients 65 years and older with mental status changes and asymptomatic bacteriuria or negative urine cultures.
Methods
A retrospective chart review was performed to evaluate patients aged 65 and older from January 2017 through June 2018 who presented to the ED from home with AMS, a urinalysis that reflexed to culture, and were admitted to an internal medicine unit. The primary outcome was defined as the percentage of patients with AMS who received antibiotics in the ED with asymptomatic bacteriuria or negative urine cultures.
Background
Altered mental status (AMS) is the most common diagnosis among those 65 and older who present to the emergency department (ED). Urinary tract infections (UTIs) account for 15.5% of hospitalizations in this population. The purpose of this study was to determine the incidence of initiation of antibiotics in the ED in patients 65 years and older with mental status changes and asymptomatic bacteriuria or negative urine cultures.
Methods
A retrospective chart review was performed to evaluate patients aged 65 and older from January 2017 through June 2018 who presented to the ED from home with AMS, a urinalysis that reflexed to culture, and were admitted to an internal medicine unit. The primary outcome was defined as the percentage of patients with AMS who received antibiotics in the ED with asymptomatic bacteriuria or negative urine cultures.
Ceftolozane-Tazobactam for the Treatment of Multidrug-Resistant Pseudomonas aeruginosa Infections: A Multicenter Study
2018
Background
Multidrug-resistant Pseudomonas aeruginosa infections remain common in hospitals worldwide. We investigated the outcomes associated with the use of ceftolozane-tazobactam for the treatment of these infections.
Methods
Data were collected retrospectively from 20 hospitals across the United States about adults who received ceftolozane-tazobactam for the treatment of multidrug-resistant P aeruginosa infections of any source for at least 24 hours. The primary outcome was a composite of 30-day and inpatient mortality, and secondary outcomes were clinical success and microbiological cure. Multivariable regression analysis was conducted to determine factors associated with outcomes.
Background
Multidrug-resistant Pseudomonas aeruginosa infections remain common in hospitals worldwide. We investigated the outcomes associated with the use of ceftolozane-tazobactam for the treatment of these infections.
Methods
Data were collected retrospectively from 20 hospitals across the United States about adults who received ceftolozane-tazobactam for the treatment of multidrug-resistant P aeruginosa infections of any source for at least 24 hours. The primary outcome was a composite of 30-day and inpatient mortality, and secondary outcomes were clinical success and microbiological cure. Multivariable regression analysis was conducted to determine factors associated with outcomes.
Multicenter study of outcomes with ceftazidime-avibactam in patients with carbapenem resistant Enterobacteriaceae infections
2017
Ceftazidime-avibactam is a novel cephalosporin-beta-lactamase inhibitor combination that is active against many carbapenem-resistant Enterobacteriaceae (CRE). We describe a retrospective chart review for 60 patients who received ceftazidime-avibactam for a CRE infection. In-hospital mortality was 32%, 53% of patients had microbiological cure, and 65% had clinical success. In this severely ill population with CRE infections, ceftazidime-avibactam was an appropriate option.
Ceftazidime-avibactam is a novel cephalosporin-beta-lactamase inhibitor combination that is active against many carbapenem-resistant Enterobacteriaceae (CRE). We describe a retrospective chart review for 60 patients who received ceftazidime-avibactam for a CRE infection. In-hospital mortality was 32%, 53% of patients had microbiological cure, and 65% had clinical success. In this severely ill population with CRE infections, ceftazidime-avibactam was an appropriate option.
Selected Honors and Awards
- One in a Million Award, Multiplying Good, 2020
Event Appearances
(2023) ASP Quarterly
2024-10-16, Whats the Word? (Babesia, Malaraia, Candidemia, and COVID update), ChristianaCare
(2023) ASP Quarterly
2024-10-16, ASP XXVII When CLSI Comes Calling, ChristianaCare
(2022) ASP Quarterly
2024-10-16, Idioms (Updates on the management of persistent Staphylococcus aureus bacteremia), ChristianaCare
(2022) ASP Quarterly
2024-10-16, Gram Negative Meningitis and Resistance, ChristianaCare
(2022) ASP Quarterly
2024-10-16, Lies Your Mother Told You (Duration of therapy for Gram Negative Bacteremia, Long acting Gram positive agents, Oral agents for endocarditis and osteomyelitis, Gram positive rods), ChristianaCare
Languages
- English
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Nicole S. Harrington, PharmD, BCPS, AQ-ID
Clinical Pharmacy Specialist
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