New at CMC3

Charlesnika Evans, PhD

2008 Fritz Krauth Memorial Fellow

The Paralyzed Veterans of America (PVA) Research Foundation awarded a one-year fellowship grant to Dr. Evans, to begin January 2008. As part of the grant, Dr. Evans was also selected as the 2008 Fritz Krauth Memorial Fellow. This fellowship was established by PVA, named after a lifetime PVA member who established a trust fund in the 1990’s to benefit PVA research upon his death. The Fritz Krauth Memorial Fellowship is bestowed annually to the highest scoring fellowship grant.

The fellowship grant is titled ‘Antibiotic Prescribing for Veterans with Spinal Cord Injury or Disease (SCI/D) and Clinician Perceptions.’ Antibiotic resistance is an increasing problem worldwide and antibiotic use is a driving force in the development of resistance. Prescribing of antibiotics has been described in a number of settings, however, these data are lacking for persons with SCI/D. Research in this population may be even more relevant because persons with SCI/D have increased antibiotic use for treatment of frequent infections. The goals of this study are to assess antibiotic prescribing trends in veterans with SCI/D over time; identify factors associated with prescribing; and determine the reasons for type of antibiotic selection by providers who care for persons with SCI/D. The grant includes salary support and travel expenses.

For the past eight years, Dr. Evans has served as the Administrative Coordinator for SCI QUERI and as an investigator on several SCI QUERI studies. With a particular focus in health outcomes research in infectious diseases, she has lead papers focused on influenza vaccinations, diagnosis and treatment, hospital-acquired infections, and on antibiotic use (1-5). The latter focus included a paper in the Journal of Antimicrobial Chemotherapy titled "Trends in antibiotic prescribing for acute respiratory infection in veterans with spinal cord injury and disorder" and is directly related to the current fellowship grant (5). The trends study demonstrated that persons with SCI&D who have acute respiratory infections may receive antibiotics more often than needed, and in many cases, a broad-spectrum antibiotic is prescribed. Overuse of antibiotics may have implications for antibiotic resistance in this population. The current fellowship will expand on this previous work.

1. Evans C, Legro M, Weaver F, Goldstein B. Influenza Vaccination Among Veterans with Spinal Cord Injury, Part 1. A survey of attitudes and behavior. J Spinal Cord Med 2003;26:204-209.

2. Evans CT, LaVela SL, Smith B, Miskevics S, Weaver FM, Goldstein B. Influenza diagnosis and treatment in veterans with spinal cord injury. Arch Phys Med Rehabil 2006;87:291-293.

3. Evans CT, LaVela SL, Smith B, Wallace C, Goldstein B, Weaver FM. Response to the 2004-2005 influenza vaccine shortage in veterans with spinal cord injuries and disorders and their providers. J Spinal Cord Med 2007;30:49-55.

4. Evans CT, LaVela SL, Weaver FM, Priebe M, Sandford P, Niemiec P, Miskevics S, Parada JP. Epidemiology of hospital-acquired infections in veterans with spinal cord injury and disorder. Infect Control Hosp Epidemiol, in press.

5. Evans CT, Smith B, Parada JP, Kurichi JE, Weaver FM. Trends in antibiotic prescribing for acute respiratory infection in veterans with spinal cord injury and disorder. J Antimicrob Chemother 2005;55:1045-1049.