Impact of a Regional Antimicrobial Stewardship on the Length of Stay of Patients Admitted to Hospital With Pneumonia (RASPCAP)
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|ClinicalTrials.gov Identifier: NCT02276092|
Recruitment Status : Completed
First Posted : October 27, 2014
Last Update Posted : January 27, 2020
|Condition or disease||Intervention/treatment|
|Pneumonia||Other: antimicrobial stewardship|
Antimicrobial stewardship is defined as any activity that promotes the appropriate selection, dosing, route and duration of antibiotic therapy. Antimicrobial stewardship programs usually include pharmacists and/or doctors with expertise in infection diseases management. Prospective chart review and physician feedback is a common intervention used by antimicrobial stewardship programs to improve antibiotic utilization and patient outcomes.
Pneumonia is the most common reason for antibiotic utilization in hospitals. Significant variation in antibiotic utilization for patients with pneumonia has been repeatedly demonstrated in published studies despite the existence of best-practice treatment guidelines. Treatment variation from these guidelines has been demonstrated to result in worse outcomes such as increased mortality. Antimicrobial stewardship programs can help reduce the treatment variation from guidelines.
Despite improvements in certain outcomes, antimicrobial stewardship programs have not demonstrated any impact on the length of stay of patients admitted to hospital with pneumonia. Part of this absence of evidence may be due to poor study design and failure to recruit sufficient patients. This study will include the implementation of an antimicrobial stewardship program across many hospitals and the study design and analysis will account for the design problems of the previous studies.
|Study Type :||Observational [Patient Registry]|
|Actual Enrollment :||1400 participants|
|Target Follow-Up Duration:||60 Days|
|Official Title:||Effectiveness of a Regional Antimicrobial Stewardship Program to Reduce the Length of Stay of Patients Admitted to Hospital With Community-acquired Pneumonia: a Pragmatic Multi-centre Clinical Study|
|Study Start Date :||April 2015|
|Actual Primary Completion Date :||March 2017|
|Actual Study Completion Date :||April 2017|
exposure to antimicrobial stewardship intervention
Other: antimicrobial stewardship
A member of the antimicrobial stewardship program will prospectively review the patient's medical record and make recommendations to the most responsible physician in the care of that patient
Other Name: prospective audit and feedback
usual care with no exposure to antimicrobial stewardship
- Length of hospital stay [ Time Frame: Days from time of admission to time of discharge from hospital to a maximum of 14 days from the date of admission (or time to censoring at 14 days from the date of admissionor competing event depending on which comes first) ]Time (measured in days) from date of admission to one of the following potential outcomes, discharge alive, censoring at 14 days post admission, death, admission to an intensive care unit, or transfer to another hospital
- Days of antibiotic therapy [ Time Frame: Days of antibiotic therapy for the treatment of pneumonia measured from the first day of antibiotic administered to the final day of antibiotic administered upto a maximum of 80 days ]Total days of antibiotics administered for the treatment of community-acquired pneumonia
- Mortality rate [ Time Frame: 30 day post-discharge from hospital ]Deaths that occur post-discharge from hospital up to 30 days post-discharge
- Readmission to hospital [ Time Frame: 30 day post-discharge from hospital ]Readmissions to hospital that occur post-discharge from hospital up to 30 days post-discharge
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02276092
|Royal Victoria Regional Health Centre|
|Barrie, Ontario, Canada, L4M6M2|
|Principal Investigator:||Giulio DiDiodato, MD||Physician|