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Keeping hospitals healthy

Sat, Mar 01, 2014

Seeing how people relied on his father, a small-town Oregon doctor, planted the seeds for a career in medicine in young Ebbing Lautenbach ’89.

“My dad had some patients for 35 years,” said Lautenbach. “You could see the depth of relationship there, and he took great satisfaction in keeping them well. Patients can tell if you care, if you have compassion. I thought I’d start down that same road and see what happened.”

Lautenbach knew of Calvin through relatives and wanted a Christian environment for his undergraduate study. He liked the college on his first visit—a “gut feeling” that Calvin was the right place.

Studies in pre-medicine confirmed his direction, and he fondly remembers his professor and pre-professional adviser Peter Tigchelaar. “How could you not be excited about medicine after spending time with Tigchelaar?” he asked.

Another pivotal Calvin experience was an interim in Kenya with sociology professor Don Wilson; Lautenbach still appreciates the “devout and genuine” worship students had with their Kenyan hosts.

Lautenbach did his medical and public health training at Columbia University in New York, where he met his wife-to-be, Gillian, also a medical student. The two chose the University of Pennsylvania for internal medicine residency partly because of its promise to coordinate working schedules so they would actually see each other during the week.

Today, both of them continue at the university’s medical center—Ebbing as the and Gillian as lead physician of one of Penn’s faculty practices, where she also mentors internal medicine residents.

Lautenbach divides his work into four areas: research, patient care, teaching and administration. He also serves as one of Penn’s hospital epidemiologists, who work to determine the cause of new patterns of antibiotic resistance and prevent hospital-associated infections.

“A hospital can’t delay in dealing with new infectious disease patterns,” he said. “I have the opportunity to make a real difference and save lives by identifying and treating a hospital-acquired infection quickly.”

The field of hospital epidemiology has gained more attention in recent years as the impact of hospital infections has become more widely recognized, he said.

“By and large you have to be pretty sick to be in the hospital these days,” Lautenbach said, “and that often means frequent courses of antibiotics. The sharp increase in bacteria resistance to one of more antibiotics has made treatment of infections, particularly in the hospital setting, more and more challenging. In fact, there are increasing instances of the infections resistant to most, if not all, routinely available antibiotics.”

Lautenbach and his team work on clinical and research protocols to optimize antibiotic use in hospitalized patients, attempting to balance the need to treat a suspected infection with the need to minimize unnecessary use of antibiotics.

“We’re developing computer-based decision support systems now, and that will be more common in the future,” he said. “Doctors want to be careful that they don’t prescribe an antibiotic that will benefit the patient, but not over-prescribe either. We want to make more data available to the medical staff to make what’s decided right for the patient—and for everyone else in the hospital, too.”

Given the fact that the development of new antibiotics has slowed down, preserving the efficacy of the drugs currently available is important, he added.

“There’s always something new on the horizon,” Lautenbach said. “Hopefully, the work we’re doing is helping patients heal and improving the hospital environment.”