Errors in Prescription Antibiotics in Ventilator-associated Pneumonia

NCT ID: NCT02074033

Last Updated: 2014-03-27

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Total Enrollment

130 participants

Study Classification

OBSERVATIONAL

Study Start Date

2014-03-31

Study Completion Date

2014-10-31

Brief Summary

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The infection is a major risk to hospitalized patients, especially those admitted to the Intensive Care Unit (ICU) and an unfavorable factor in the outcome of critically ill patients, increasing costs and prolonging hospitalization hospitalar. The ventilator-associated pneumonia (PAV) is considered the most prevalent nosocomial infection in the ICU, occurring in 9% to 68% of patients with prosthetic ventilatória.Due to the high rate of PAV and mortality related to it, is very important both prescription and administration of antibiotics correctly, as deescalation or escalation according the result of cultures.Therefore, the objectives of this study is assess if whether the antibiotic prescribed of ventilator-associated pneumonia following the orientation of literature. Will also be assessed the rate of PAV in patients critically ill adults, the main microorganisms responsible by PAV and determining antimicrobial susceptibility.

Detailed Description

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In patients who had a diagnosis of ventilator-associated pneumonia by asssistente physician will be assessed initially prescribed antibiotics empirically and what conduct adopted after culture results.

We will be examined whether the antibiotic prescribed following the orientation of literature, considering the dose, interval between doses, dose adjustment for renal failure infusion time, treatment time and conduct after the culture results (deescalation, escalation or maintenance of antimicrobial initially prescribed ) . The deescalation consists of discontinuing the use of antimicrobial or antibiotic change to another with lower coverage and spectrum is performed, escalation occurs when adding a new antibiotic or antibiotic to change the coverage of other larger spectrum after culture results .

Conditions

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Pneumonia

Study Design

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Study Time Perspective

RETROSPECTIVE

Study Groups

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antibiotics for pneumonia

We will be examined whether the antibiotic prescribed following the orientation of literature, considering the dose, interval between doses, dose adjustment for renal failure infusion time, treatment time and conduct after the culture results (deescalation, escalation or maintenance of antimicrobial initially prescribed )

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

* Be 18 years of age;
* Having the diagnosis of ventilator-associated pneumonia.

Exclusion Criteria

* Be under 18 years of age;
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Federal University of Uberlandia

OTHER

Sponsor Role lead

Responsible Party

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Ana Carolina Souza Oliveira

graduate student

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Ana Carolina Souza Oliveira

Role: PRINCIPAL_INVESTIGATOR

Federal University of Uberlandia

Denise Von Dollinger de Brito

Role: PRINCIPAL_INVESTIGATOR

Federal University of Uberlandia

Thúlio Marquez Cunha

Role: PRINCIPAL_INVESTIGATOR

Federal University of Uberlandia

Fabiola Alves Gomes

Role: PRINCIPAL_INVESTIGATOR

Federal University of Uberlandia

Locations

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Ana Carolina Souza Oliveira

Uberlândia, Minas Gerais, Brazil

Site Status RECRUITING

Countries

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Brazil

Central Contacts

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Ana Carolina Souza Oliveira

Role: CONTACT

055343182150

Related Links

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http://www.ncbi.nlm.nih.gov/pubmed

Guidelines for the Management of Adults with Hospital-acquired, Ventilator-associated, and Healthcare-associated Pneumonia. American Journal of Respiratory and Critical Care Medicine, New

http://www.ncbi.nlm.nih.gov/pubmed

ALVAREZ-LERMA, F. et al. Empiric broad-spectrum antibiotic therapy of nosocomial pneumonia in the intensive care unit: A prospective observational study. Crit Care, London, v.10, n.3, p.1-11, May 2006.

http://www.ncbi.nlm.nih.gov/pubmed

ANGUS, D.C.et al. Epidemiology of severe sepsis in the United States: analysis of incidence, outcome and associa¬ted costs of care. Crit Care Med, New York, v.29, n.7, p.1303-1310, Jul 2001.

http://www.ncbi.nlm.nih.gov/pubmed

BURKE, J.P. Infection control- a problem for patient safety. N Engl J Med, Melbourn, v.348, n.7, p. 651-656, Feb 2003.

http://www.ncbi.nlm.nih.gov/pubmed

CAMARGO, L. F. A. et al. Ventilator associated pneumonia: comparison between quantitative and qualitative cultures of tracheal aspirates. Critical Care Medicine, New York, v.8, n.6, p. 422-430, Dec 2004.

http://www.ncbi.nlm.nih.gov/pubmed

EACHEMPATI, S.R. et al. Does de-escalation of antibiotic therapy for ventilator-associated pneumonia affect the likelihood of recurrent pneumonia or mortality in critically ill surgical patients? J Trauma, Baltimore, v.66, n.5, p.1343-1348, May 2009.

http://www.ncbi.nlm.nih.gov/pubmed

ERBAY, A., BODUR, H., AKINCI, E., ÇOLPAN, A. Evaluation of antibiotic use in intensive care units of a tertiary care hospital in Turkey. Journal of Hospital Infection, New York , v.59, p.53-61, Jan 2005.

http://www.ncbi.nlm.nih.gov/pubmed

GOMES SILVA, B.N. et al. De-escalation of antimicrobial treatment for adults with sepsis, severe sepsis or septic shock. Cochrane Database Syst Rev, Oxford,v.8, n.12, CD007934, Dec 2010.

http://www.ncbi.nlm.nih.gov/pubmed

HEENEN, S., JACOBS, F., VINCENT,J-P. Antibiotic strategies in severe nosocomial sepsis: Why do we not de-escalate more often? Crit Care Med, New York, v.40, n.5, p.1404-1409, May 2012 .

http://www.ncbi.nlm.nih.gov/pubmed

RELLO, J. et al. De-escalation therapy in ventilator associated pneumonia. Crit Care Med , New York, v.32, n.11, p.2183-2190, Nov 2004.

http://www.ncbi.nlm.nih.gov/pubmed

SAFDAR, N.; CRNICH, C.J.; MAKI, D.G. The Pathogenesis of Ventilator-Associated Pneumonia: Its Relevance to Developing Effective Strategies for Prevention. Respiratory Care, Philadelphia, v.50, n.6, p.725-739, Jun 2005.

http://www.ncbi.nlm.nih.gov/pubmed

WAELE, J.J.D.et al. De-escalation after empirical meropenem treatment in the intensive care unit: Fiction or reality? Journal of Critical Care, Orlando, v.25, n.4, p.641-646, Jan 2010.

Other Identifiers

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30121978

Identifier Type: -

Identifier Source: org_study_id

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