Impact of Infectious Diseases Specialists on the Appropriateness of Antimicrobial Therapy in Surgical and Medical Wards (ATBREFSURMED)
Recruitment status was Not yet recruiting
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Purpose
CONTEXT: Antibiotics are frequently used in hospital but the appropriateness of prescriptions ranged between 25-50%. The intervention of infectious disease specialists (IDS) could improve the appropriateness of prescriptions and reduce their use. The impact of IDS has not been yet fully estimated using a randomized trial to compare the quality of care of patients who will benefit of the intervention.
OBJECTIVES: To show using a randomized trial that patients with IDS advice will receive more appropriate antimicrobial therapy but less exposure to antibiotics, as compared to patients who will not receive IDS advice.
METHODS: Prospective randomized trial comparing antibiotic exposure and appropriateness of prescriptions in two groups of patients:
- Control group: antibiotic prescriptions will be initiated and managed by the attending physicians
- Intervention group: antibiotic prescriptions will be systematically evaluated by the IDS and changed if judged necessary by the attending physicians, following IDS' advice.
STUDY PROCESS: The study will took place in 4 university hospitals. Two medical or surgical wards will participate by hospital. For each ward, the period of the study will be 2 x 4 weeks.Total duration of the study: 12 months.
| Condition | Intervention |
|---|---|
|
Patients Receiving Antimicrobial Therapy |
Other: Infectious disease specialist advice |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Single Blind (Outcomes Assessor) Primary Purpose: Treatment |
| Official Title: | Impact of Infectious Diseases Specialists on the Appropriateness of Antimicrobial Therapy in Surgical and Medical Wards: a Multicenter Randomized Controlled Trial. |
- Appropriateness of antimicrobial therapy [ Time Frame: Between days 7 and 10 after starting antimicrobial therapy ] [ Designated as safety issue: No ]Appropriateness of antimicrobial therapy will be evaluated at the start, between days 3 and 5, and at the end of therapy (between days 7 and 10).
- Clinical impact [ Time Frame: Between days 7 and 10 after starting antimicrobial therapy ] [ Designated as safety issue: No ]Length of hospitalization;clinical outcome: resolution of infection; in hospital mortality
- Antibiotic exposure [ Time Frame: 14 days ] [ Designated as safety issue: No ]
Antibiotic exposure will be evaluated using the following parameters:
number of days of therapy/numbers of days of hospitalization; defined daily doses of antibiotic/number of days of hospitalization
| Estimated Enrollment: | 248 |
| Study Start Date: | June 2010 |
| Estimated Study Completion Date: | June 2011 |
| Estimated Primary Completion Date: | May 2011 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Infectious disease specialist advice
Patients receiving the intervention (infectious disease specialist advice)
|
Other: Infectious disease specialist advice
Indication, choice, dosing and duration of antimicrobial therapy
|
|
No Intervention: Control
Patients not receiving infectious disease specialist advice
|
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Adults
- Hospitalized in surgical or medical wards
- Receiving antimicrobial therapy for active infection or prolonged surgical prophylaxis
- Therapy prescribed by the attending ward physician
Exclusion Criteria:
- Patients receiving antimicrobial therapy not prescribed by the attending ward physician
Contacts and Locations| Contact: Philippe Lesprit, MD | 33149814691 | philippe.lesprit@hmn.aphp.fr |
| Contact: Caroline Quintin | 33133140257966 | caroline.quintin@bch.aphp.fr |
| France | |
| Henri Mondor University Hospital | Not yet recruiting |
| Créteil, France, 94010 | |
| Contact: Philippe Lesprit, MD 33149814691 philippe.lesprit@hmn.aphp.fr | |
| Principal Investigator: | Philippe Lesprit, MD | Assistance Publique - Hôpitaux de Paris |
More Information
No publications provided
| Responsible Party: | Dr P. Lesprit, Hôpital Henri Mondor, Assistance Publique Hôpitaux de Paris, Unité de Contrôle Epidémiologie Prévention de l'Infection |
| ClinicalTrials.gov Identifier: | NCT01136200 History of Changes |
| Other Study ID Numbers: | PREQHOS 08023 |
| Study First Received: | May 28, 2010 |
| Last Updated: | June 2, 2010 |
| Health Authority: | France: Ministry of Health |
Keywords provided by Henri Mondor University Hospital:
|
Surgical and medical wards Adults Antimicrobial therapy |
Additional relevant MeSH terms:
|
Communicable Diseases Infection Anti-Infective Agents Therapeutic Uses Pharmacologic Actions |
ClinicalTrials.gov processed this record on May 19, 2013