Impact of a Regional Antimicrobial Stewardship on the Length of Stay of Patients Admitted to Hospital With Pneumonia
NCT ID: NCT02276092
Last Updated: 2020-01-27
Study Results
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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COMPLETED
1400 participants
OBSERVATIONAL
2015-04-30
2017-04-30
Brief Summary
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Detailed Description
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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.
Conditions
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Study Design
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COHORT
PROSPECTIVE
Study Groups
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intervention
exposure to antimicrobial stewardship intervention
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
control
usual care with no exposure to antimicrobial stewardship
No interventions assigned to this group
Interventions
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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 Intervention Names
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Eligibility Criteria
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Inclusion Criteria
* Immunocompetent
* Age \> 18 years
Exclusion Criteria
* Requiring invasive or non-invasive ventilation
* Life expectancy less than 3 months
* Hospitalization within the previous 3 months for at least 48 consecutive hours
* Immunocompromised defined as defined as having leukemia, lymphoma, HIV with CD4 count \<=200, splenectomy or on cytotoxic chemotherapy
* Neutropenic \[defined as a PMN count\<=0.5x109 cells/L\] from any cause
* Receiving immunosuppressants \[defined as \>=40 mg prednisone daily (or steroid equivalent) for \>=2 weeks preceding hospitalization OR any other immunosuppressant used for systemic illness OR to prevent transplant rejection
18 Years
ALL
No
Sponsors
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Royal Victoria Hospital, Canada
OTHER
Responsible Party
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Giulio DiDiodato
principal investigator
Principal Investigators
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Giulio DiDiodato, MD
Role: PRINCIPAL_INVESTIGATOR
Physician
Locations
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Royal Victoria Regional Health Centre
Barrie, Ontario, Canada
Countries
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Other Identifiers
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RASP2013
Identifier Type: -
Identifier Source: org_study_id
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