Patients Receiving Antimicrobial Therapy
Conditions
Keywords
Surgical and medical wards, Adults, Antimicrobial therapy
Brief summary
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.
Interventions
Indication, choice, dosing and duration of antimicrobial therapy
Sponsors
Henri Mondor University Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
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
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Appropriateness of antimicrobial therapy | Between days 7 and 10 after starting antimicrobial therapy | 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). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Clinical impact | Between days 7 and 10 after starting antimicrobial therapy | Length of hospitalization;clinical outcome: resolution of infection; in hospital mortality |
| Antibiotic exposure | 14 days | 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 |
Countries
France
Outcome results
None listed