Infection Infections and Infestations Infection
Conditions
Interventions
Current:
This study is a pragmatic, multi-centre, randomised controlled trial in adults with ARI admitted to University Hospital Southampton NHS Foundation Trust or Hampshire Hospitals
Sponsors
University Hospital Southampton NHS Foundation Trust
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1. Is a patient in the ED* or AMU at University Hospital Southampton NHS Foundation Trust (UHS) or [added 01/05/2019]: Hampshire Hospitals Foundation NHS Trust 2. Aged =18 years old 3. Has acute respiratory illness** 4. Duration of respiratory illness less than 10 days prior to hospitalisation 5. Can be recruited to the study within 16 hours of presentation *For patients in ED a decision will have already been made that the patient will be admitted. **An episode of acute respiratory illness is defined as an acute pulmonary illness (including pneumonia, bronchitis and influenza-like illness) or an acute exacerbation of a chronic respiratory illness (including exacerbation of COPD, asthma or bronchiectasis). For the study, acute respiratory illness as a provisional, working, differential or confirmed diagnosis must be made by a treating clinician.
Exclusion criteria
Exclusion criteria: 1. Not fulfilling all the inclusion criteria 2. A purely palliative approach being taken by the treating clinicians 3. Previously included in this study and re-presenting within the last 30 days after hospital discharge 4. Declines nasal / pharyngeal swabbing 5. Consent declined or consultee consent declined 6. Concurrent, prior or subsequent enrolment in an observational study is not necessarily an exclusion criterion; this is at the discretion of the chief investigator and will be assessed on a case-by-case basis.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Difference in the proportion of influenza positive patients treated appropriately with neuraminidase inhibitors (NAI) within 5 days of admission. | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Proportion of cases of influenza identified 2. Proportion of cases of all respiratory viruses detected 3. Proportion of all NAI use occurring in influenza positive patients 4. Proportion of all NAI use occurring in influenza negative patients 5. Time from admission to NAI commencement in hours 6. Duration of NAI use in influenza positive patients, days and doses 7. Duration of NAI use in influenza negative patients, days and doses 8. Proportion of patients treated with antibiotics 9. Proportion of patients treated with single doses or brief courses (<48 hours) of antibiotics 10. Duration of antibiotic use in days 11. Proportion of patients isolated in a side room 12. Duration of isolation facility use 13. Proportion of influenza cases correctly isolated 14. Time from admission to isolation of influenza positive cases 15. Time from admission to de-isolation of influenza negative cases 16. Duration of hospitalisation in days 17. Time to clinical stability* in days 18. Time on supplementary oxygen in days 19. Proportion of patients with ICU or HDU admission 20. Duration of ICU or HDU stay in days 21. Proportion re-presenting to hospital within 30 days 22. Proportion readmitted to hospital within 30 days 23. In hospital, 30 and 60 day mortality 24. Turn-around time for viral testing All outcomes are measured for the duration of hospitalisation or up to 30 days (whichever is shortest) unless specified otherwise and include medication (antibiotics and NAIs) that patients are discharged home with. *Defined as: temperature =37.8C, respiratory rate =24 breaths per minute, heart | — |
Countries
United Kingdom
Outcome results
None listed