Programs

In 2010, we established the Antimicrobial Stewardship Program in response to the increasing epidemic of drug resistant organisms in the hospital setting. Stewardship programs were formed in many hospitals in the country at this time, as the largely educational approach to use antibiotics rationally failed to reduce antibiotic overuse. The genesis of the program nationwide was to curb unnecessary antimicrobial use in order to reduce wasteful use of limited and non-renewable resources (e.g., antibiotics that are active against bacteria as they exist today), minimize harm to the patient (by avoiding unnecessary adverse reactions, superinfections, and Clostridia difficile infection) and avoid the never ceasing process of resistant microbes.

Our program received the Antimicrobial Stewardship Centers of Excellence(link is external) designation from the Infectious Diseases Society of America, which recognizes institutions that achieve standards established by the Centers for Disease Control and Prevention for antimicrobial stewardship programs led by infectious diseases physicians and infectious diseases-trained pharmacists.

Dr. Tejal Gandhi serves as the medical director of our Antimicrobial Stewardship Program. The program provides general education services to clinical teams throughout the hospital, as well as individual feedback to physicians who have prescribed an antibiotic that does not meet established indications and advice on administering an effective, alternate antibiotic. Moreover, using a formulary of restricted antibiotics, the program has reduced inappropriate use of newer agents through a process of prior authorization. The program has resulted in a substantial reduction of inappropriate antibiotic use.

TheFecal Microbiota Transplant Program was established in 2013 and was implemented to address the rising number of patients being diagnosed with recurrent Clostridium difficile infection, also called CDI or C. diff., a serious bacterial infection that can cause inflammation of the colon, diarrhea, fever, and abdominal cramps, and can sometimes result in death. C. diff primarily occurs when the indigenous bacteria in a person’s gut is removed by an antibiotic being used to treat a separate condition, thereby hindering the body’s ability to fight off C. diff.

Fecal Microbiota Transplant (FMT) is a procedure where healthy fecal material is placed into a person infected with C. diff. The goal of the FMT procedure is to repopulate the colon with healthy bacteria in the infected person and cure them of C. diff.

The program team currently consists of a pharmacist and nearly 10 physicians coming from the Divisions of Infectious Diseases and Gastroenterology and Hepatology, and is directed by Krishna Rao, MD, MS.

In 1995, in response to the AIDS epidemic, we established the HIV/AIDS Treatment Program (HATP), with Dr. Powel H. Kazanjian as the director. The program provides comprehensive care for the whole person. We utilize a multi-focused team approach that addresses not only the patient's medical needs, but also psychosocial needs. 

Mission and Goals

Our HIV/AIDS Treatment Program describes its mission with three goals:

• Provide excellent comprehensive and longitudinal primary and specialty care for all people living with HIV/AIDS.
• Provide education and training along standards of quality related to HIV/AIDS care to other health providers, both within and outside of Michigan Medicine.
• Maintain an active clinical research program, offering expanded access to new and promising treatments for all people living with HIV/AIDS.

Meet the Team

• Powel Kazanjian, MD, PhD (Medical Director) – Division Chief and Professor of Internal Medicine, Professor of Epidemiology, and Professor of History
• Sandro Cinti, MD – Professor of Internal Medicine
• Tejal Gandhi, MD – Associate Professor of Internal Medicine
• Kevin Gregg, MD – Associate Professor of Internal Medicine
• Daniel Kaul, MD – Professor of Internal Medicine
• James Riddell IV, MD – Professor of Internal Medicine

Research

In the past, we have focused our research efforts on the development of many of the antiretroviral medications that are presently in common use today. Currently, we are working on finding more long- term curative therapies by studying the HIV reservoir. In particular, we are interested in bone marrow stem cells as a reservoir site, as well as immune cells associated with the GI tract. We also are investigating strategies to improve HIV adherence in Mozambique. All of these studies are collaborative in nature and involve large teams leveraging their individual areas of expertise to solve complex problems.

Faculty Publications

• Powel Kazanjian, MD, PhD
• Sandro Cinti, MD
• Tejal Gandhi, MD
• Kevin Gregg, MD
• Daniel Kaul, MD
• James Riddell IV, MD 

Grants

Our HIV/AIDS Treatment Program (HATP) has received funding from the Health Resources and Services Administration’s (HRSA) Ryan White HIV/AIDS Program since 1995. The Ryan White HIV/AIDS Program funds grants to states, cities/counties, and local community-based organizations to provide care and treatment services to people living with HIV to improve health outcomes and reduce HIV transmission among hard-to-reach populations.

Our program currently receives Ryan White HIV/AIDS Program Part C funding from HRSA and Part B funding through the Michigan Department of Health and Human Services (MDHHS). Additionally, MDHHS also funds the HATP for tobacco cessation services. The HATP is funded to provide primary medical care services, mental health services, psychiatric services, nutritional services, medical case management, and emergency financial assistance. 

Patient Care

Please visit the HIV/AIDS Treatment Program on UofMHealth.org for more information.

Support Our Work

Making a gift to our program will support our research and understanding of HIV and AIDS in order to advance patient care. To make a gift, please visit the HIV/Aids Education & Research online giving page.

Endocarditis is an infection of the heart valves which can cause severe illness involving many organ systems. To optimally care for patients with this infection a team approach is needed. This team includes specialists from Infectious Diseases, Cardiology, Neurology, and Cardiac surgery. In addition, Internists, Interventional Radiologists, Nuclear Medicine physicians, Addiction Medicine providers and other health care providers join on an as needed basis. Since the multidisciplinary approach began, significant improvements to patient outcomes have been observed. Dr. Megan Neils has been the director of the MET since 2020. 

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