Antimicrobial Stewardship Program and Ventilator Associated Pneumonia
|ClinicalTrials.gov Identifier: NCT04097899|
Recruitment Status : Completed
First Posted : September 20, 2019
Last Update Posted : September 20, 2019
|Condition or disease||Intervention/treatment|
|Ventilator Associated Pneumonia||Other: implementation of antimicrobial stewardship comprehensive care bundle program on ventilator associated pneumonia patients|
Survey experimental study will be done in the first 6 months as regard antimicrobial drugs pattern and organism's sensitivity and resistance pattern in VAP patients.
In the next six months, clinical implementation of ASPs and infection control bundle will be applied on VAP patients. Then, in the later six months the investigators will study the outcome of VAP patients as regard:
- Amount of cost of antibiotics.
- Appropriates of antibiotic use (initiation, duration & time of discontinuation).
- Rate of resistance
- Clinical outcome, infection rate &length of stay.
Regular reports on antibiotic use and resistance will be admitted to relevant staff every one month. Also, audit and feedback about resistance and optimal prescribing will be applied every one month for ICU stuff as an open discussion.
The stewardship consulting team will include microbiologist with clinical experience in the field of antibiotic use and infection control. Stewardship team also will include the relevant ICU staff and an experienced clinical pharmacist.
|Study Type :||Observational|
|Actual Enrollment :||25 participants|
|Official Title:||Impact of Implementation of Antimicrobial Stewardship Comprehensive Care Bundle Program on Ventilator Associated Pneumonia in Surgical Intensive Care Unit|
|Actual Study Start Date :||July 1, 2016|
|Actual Primary Completion Date :||December 31, 2017|
|Actual Study Completion Date :||December 31, 2017|
Group A in preimplementation phase
Patient and antibiotic related data were collected to calculate and define; ventilator associated pneumonia incidence, mean ventilation days and mean length of stay, antibiotic selection, antibiotic cost, antibiotic susceptibility pattern, antibiotic consumption.
Group B in postimplementation phase
The appropriateness of antibiotic use (selection, initiation, duration & time of discontinuation) before and after implementing the educational program was compared, calculation of the change in the ventilator associated pneumonia incidence & length of ICU stay, calculation of the change in the rate of antibiotic resistance and calculation of the cost change of antibiotics used after implementing the educational program.
Other: implementation of antimicrobial stewardship comprehensive care bundle program on ventilator associated pneumonia patients
Construction of a comprehensive care bundle educational program. This program consisted of many elements: Antimicrobial stewardship programs, VAP bundles and infection control policy implementation and the investigators studied the impact of this program on:
- change in ventilator associated pneumonia incidence [ Time Frame: 18 months ]After implementation of the Antimicrobial Stewardship Comprehensive Care Bundle Program (ASCCBP), the percentage of VAP incidence was measured to assess the effectiveness of the program.
- change in antibiotic resistance pattern [ Time Frame: 18 months ]measuring the change in sensitivity and resistance pattern of antibiotics used in ICU was done by assessing the change in the sputum culture and sensitivity results.
- ventilation days [ Time Frame: 18 months ]Days of mechanical ventilation of each patient were measured to calculate the difference before and after implementation of the program.
- antibiotic cost [ Time Frame: 18 months ]costs of antibiotics by Egyptian pounds were calculated to assess the effectiveness of the program
Biospecimen Retention: Samples Without DNA
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT04097899
|Principal Investigator:||michael shaker, MD||faculty of medicine, Helwan university, Egypt|
|Study Director:||Heba Matar, MD||faculty of medicine, zagazig university, Egypt|
|Study Director:||sahar saad-eldeen, MD||faculty of medicine, zagazig university, Egypt|
|Study Director:||Rehab elsokkary, MD||faculty of medicine, zagazig university, Egypt|