Study Results
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Basic Information
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UNKNOWN
NA
900 participants
INTERVENTIONAL
2019-07-09
2022-12-31
Brief Summary
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The study will be carried out in 14 hospitals of the Andalusian Public Health System with representation from all the provinces and has been designed in two phases:
1. A first phase in which an observational study of historical preintervention cohorts of patients who have received either empirical or targeted treatment with ceftaroline, tedizolid, dalbavancin, ceftazidime-avibactam, ceftolozane-tazobactam and isavuconazole from January 2016 to December 2019 will be developed. Case detection will be carried out by locating the antimicrobial prescriptions in the electronic prescribing systems and / or pharmaceutical management systems of each hospital. A set of epidemiological, clinical, microbiological and prognostic variables will be completed in each case.
2. A second phase or intervention period that will be applied to the cohort of patients treated with new antibiotics (intervention cohort) from January 2020 to June 2021. A quasi-experimental intervention study will be carried out through the development of a Program for Optimizing the use of Antibiotics (PROA) in Spanish, Antimicrobial Stewardship Program (ASP) in English, in the participating hospitals. It will consist in the development of a consensus document on the use of new antibiotics following a Delphi methodology, dissemination of the consensus document / guide among the participating hospitals and audit on the prescription of new antimicrobials after the implementation of the guide based on providing non-imposition advice and positive reinforcement to the prescriber. The recommendations will be consigned in a structured form, which will allow to evaluate the degree of follow-up of the recommendations. The audit will be performed on day 0-1 of the prescription.
3. Cohort of bacteremia due to multiresistant microorganisms ("safety" cohort): In order to evaluate the safety of the use of new antimicrobials against therapeutic alternatives in syndromes where they are potentially a preferred option and parallel to the two phases, episodes for bacteremia by carbapenem-resistant Acinetobacter baumannii and Pseudomonas aeruginosa, carbapenem-resistant enterobacteria, vancomycin-resistant Enterococcus faecium and methicillin-resistant Staphylococcus aureus occurred in participating hospitals from 2017 to 2021 will be collected.
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Detailed Description
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Conditions
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Study Design
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NON_RANDOMIZED
SEQUENTIAL
TREATMENT
NONE
Study Groups
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Pre-intervention Cohort
Cohort of patients who have received either empirical or targeted treatment with ceftaroline, tedizolid, dalbavancin, ceftazidime-avibactam, ceftolozane-tazobactam or isavuconazole from January 2016 to December 2019 will be included.
No interventions assigned to this group
Intervention cohort
Cohort of patients with complex infections treated with ceftaroline, tedizolid, dalbavancin, ceftazidime-avibactam, ceftolozane-tazobactam or isavuconazole from January 2010 to June 2021.
Non-impositive Program for Optimizing the Use of Antimicrobials
Quasi-experimental intervention through the development of a Program for Optimizing the Use of Antimicrobials in the participating hospitals. The intervention will consist of the development of a consensus guide on the use of new antibiotics, its dissemination in Andalusian hospitals and an audit on the prescription of new antibiotics.
Safety cohort
Cohort of patients with bacteremia due to carbapenem-resistant Acinetobacter baumannii and Pseudomonas aeruginosa, carbapenem-resistant enterobacteria, vancomycin-resistant Enterococcus faecium and methicillin-resistant Staphylococcus aureus occurred in participating hospitals from 2017 to 2021 will be collected.
No interventions assigned to this group
Interventions
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Non-impositive Program for Optimizing the Use of Antimicrobials
Quasi-experimental intervention through the development of a Program for Optimizing the Use of Antimicrobials in the participating hospitals. The intervention will consist of the development of a consensus guide on the use of new antibiotics, its dissemination in Andalusian hospitals and an audit on the prescription of new antibiotics.
Eligibility Criteria
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Inclusion Criteria
* In a hospital or ambulatory regime.
* That they have received at least 1 dose of treatment of any of the antimicrobials mentioned, either as empirical or directed treatment.
* Adults (18 years).
* Between January 1, 2016 and December 31, 2019.
* All patients treated with ceftaroline, tedizolid, dalbavancin, ceftazidime-avibactam, ceftolozane-tazobactam or isavuconazole.
* In a hospital or ambulatory regime.
* That they have received at least 1 dose of treatment of any of the antimicrobials mentioned, either as empirical or directed treatment.
* Adults (18 years).
* From January 1, 2020 to December 31, 2021.
* Since the publication and diffusion of the recommendation guide.
* All episodes of clinically significant bacteremia (that have received any treatment) produced by:
* Acinetobacter baumannii resistant or with intermediate susceptibility to any carbapenem.
* Pseudomonas aeruginosa resistant or with intermediate susceptibility to any carbapenem.
* Enterobacteria resistant or with intermediate susceptibility to any carbapenem.
* Vancomycin-resistant Enterococcus faecium.
* Methicillin-resistant Staphylococcus aureus.
* From January 1, 2017 to December 31, 2021.
* Adult patients (18 years old).
Exclusion Criteria
Safety cohort:
18 Years
ALL
No
Sponsors
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Fundación Pública Andaluza para la gestión de la Investigación en Sevilla
OTHER
Responsible Party
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Principal Investigators
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Zaira Palacios Baena
Role: PRINCIPAL_INVESTIGATOR
University Hospital Virgen Macarena
Locations
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Hospital de Poniente-El Ejido
Almería, , Spain
University Hospital Puerta del Mar
Cadiz, , Spain
University Hospital Reina Sofía
Córdoba, , Spain
Hospital Clínico Universitario San Cecilio
Granada, , Spain
University Hospital Virgen de las Nieves
Granada, , Spain
Área Hospitalaria Juan Ramón Jiménez
Huelva, , Spain
Complejo Hospitalario de Jaén
Jaén, , Spain
University Hospital de Jerez de la Frontera
Jerez de la Frontera, , Spain
Hospital Regional Universitario de Málaga
Málaga, , Spain
University Hospital Virgen de la Victoria
Málaga, , Spain
Hospital de Puerto Real
Puerto Real, , Spain
University Hospital Virgen de Valme
Seville, , Spain
University Hospital Virgen del Rocío
Seville, , Spain
University Hospital Virgen Macarena (Sevilla).
Seville, , Spain
Countries
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Central Contacts
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Facility Contacts
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References
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Lopez Cortes LE, Mujal Martinez A, Fernandez Martinez de Mandojana M, Martin N, Gil Bermejo M, Sola Aznar J, Villegas Bruguera E, Pelaez Cantero MJ, Retamar Gentil P, Delgado Vicente M, Gonzalez-Ramallo VJ, Ponce Gonzalez MA, Miron Rubio M, Gomez Rodriguez de Mendarozqueta MM, Goenaga Sanchez MA, Sanroma Mendizabal P, Delgado Mejia E, Pajaron Guerrero M; Sociedad Espanola de Enfermedades Infecciosas y Microbiologia Clinica (SEIMC), the Sociedad Espanola de Hospitalizacion a Domicilio (SEHAD) Group. Executive summary of outpatient parenteral antimicrobial therapy: Guidelines of the Spanish Society of Clinical Microbiology and Infectious Diseases and the Spanish Domiciliary Hospitalisation Society. Enferm Infecc Microbiol Clin (Engl Ed). 2019 Jun-Jul;37(6):405-409. doi: 10.1016/j.eimc.2018.03.012. Epub 2018 May 18. English, Spanish.
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Rodriguez-Bano J, Pano-Pardo JR, Alvarez-Rocha L, Asensio A, Calbo E, Cercenado E, Cisneros JM, Cobo J, Delgado O, Garnacho-Montero J, Grau S, Horcajada JP, Hornero A, Murillas-Angoiti J, Oliver A, Padilla B, Pasquau J, Pujol M, Ruiz-Garbajosa P, San Juan R, Sierra R; GEIH-SEIMC; SEFH; SEMPSPH. [Programs for optimizing the use of antibiotics (PROA) in Spanish hospitals: GEIH-SEIMC, SEFH and SEMPSPH consensus document]. Farm Hosp. 2012 Jan-Feb;36(1):33.e1-30. doi: 10.1016/j.farma.2011.10.001. Epub 2011 Dec 1. Spanish.
Programa integral de prevención y control de las infecciones relacionadas con la asistencia sanitaria y uso apropiado de los antimicrobianos (PIRASOA). pirasoa.iavante.es/
European Centre for Disease Prevention and Control. Rapid risk assessment: Carbapenem-resistant Enterobacteriaceae - first update 4 June 2018. Stockholm: ECDC; 2018. https://ecdc.europa.eu/sites/portal/files/documents/RRA-Enterobacteriaceae-Carbapenems-European-Union-countries.pdf
Lopez-Cerero L, Egea P, Gracia-Ahufinger I, Gonzalez-Padilla M, Rodriguez-Lopez F, Rodriguez-Bano J, Pascual A. Characterisation of the first ongoing outbreak due to KPC-3-producing Klebsiella pneumoniae (ST512) in Spain. Int J Antimicrob Agents. 2014 Dec;44(6):538-40. doi: 10.1016/j.ijantimicag.2014.08.006. Epub 2014 Sep 26.
PIRASOA: actividad laboratorio de referencia. Accesible en: pirasoa.iavante.es/mod/resource/view.php?id=797
Rodriguez-Bano J, Gutierrez-Gutierrez B, Machuca I, Pascual A. Treatment of Infections Caused by Extended-Spectrum-Beta-Lactamase-, AmpC-, and Carbapenemase-Producing Enterobacteriaceae. Clin Microbiol Rev. 2018 Feb 14;31(2):e00079-17. doi: 10.1128/CMR.00079-17. Print 2018 Apr.
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Ficha técnica de ceftarolina. https://ec.europa.eu/health/documents/communityregister/2012/20120823123835/anx_123835_es.pdf
Ficha técnica de tedizolid. http://www.ema.europa.eu/docs/es_ES/document_library /EPAR_-_Product_Information/human/002846/WC500184802.pdf
Informa de posicionamiento terapéutico de dalbavancina. https://www.aemps.gob.es/medicamentosUsoHumano/informesPublicos/docs/IPTdalbavancina-Xydalba.pdf
Ficha técnica de ceftazidima-avibactam. http://www.ema.europa.eu/docs/es_ES /document_library /EPAR_-_Product_Information/human/004027/WC500210234.pdf
Ficha técnica de ceftolozano-tazobactam. https://ec.europa.eu/health/documents /communityregister/2015/20150918132786/anx_132786_es.pdf
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Palacios-Baena ZR, Valiente de Santis L, Maldonado N, Rosso-Fernandez CM, Borreguero I, Herrero-Rodriguez C, Lopez-Cardenas S, Martinez-Marcos FJ, Martin-Aspas A, Jimenez-Aguilar P, Caston JJ, Anguita-Santos F, Ojeda-Burgos G, Aznarte-Padial MP, Praena-Segovia J, Corzo-Delgado JE, Esteban-Moreno MA, Rodriguez-Bano J, Retamar P. Quasiexperimental intervention study protocol to optimise the use of new antibiotics in Spain: the NEW_SAFE project. BMJ Open. 2020 Jul 31;10(7):e035460. doi: 10.1136/bmjopen-2019-035460.
Other Identifiers
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FIS-TED-2019-01
Identifier Type: -
Identifier Source: org_study_id
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