Optimizing Antibiotic Use in Neonatal Intensive Care Units in China

NCT ID: NCT05073549

Last Updated: 2022-10-25

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

Clinical Phase

NA

Total Enrollment

10000 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-10-01

Study Completion Date

2023-12-31

Brief Summary

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This project aims to reduce antibiotic use in Chinese neonatal intensive care units (NICU) by 1) developing an adaptable framework of NICU-targeted antimicrobial stewardship programs (ASP); 2) implementing the NICU-targeted ASP in NICUs using a collaborative quality improvement method; and 3) evaluating the impact of ASP implementation on neonatal antibiotic use.

Detailed Description

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Antibiotics overuse has been a critical problem in Chinese NICUs associated with the emerging antimicrobial resistance crisis. NICU-targeted ASP have rarely been implemented in Chinese NICUs. Collaborative quality improvement methods have been shown to facilitate clinical practice changes and improve outcomes.

In this two-year interventional pre-and post-study, a NICU-targeted ASP will be developed and implemented in Chinese NICUs using the collaborative quality improvement method. The investigators hypothesize that implementing the targeted ASP using a collaborative quality improvement method will reduce the overall antibiotic days of therapy by 20% over a two-year period, comparing the last year of intervention and the last year of baseline period before ASP implementation.

Conditions

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Neonates

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Pre- and post-study

* The period from October 1st, 2019 to September 30th, 2021 will be used as the baseline period before the intervention. Clinical data of eligible infants in this period will be retrospectively collected from a previously established database of preterm infants.
* The intervention will be initiated on October 1st, 2021. The period from October 1st, 2021 to September 31st, 2023 will be the intervention period and data will be prospectively collected.
Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

NONE

Study Groups

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Collaborative antimicrobial stewardship group

Collaborative antimicrobial stewardship intervention will be implemented in NICUs of this group.

Group Type EXPERIMENTAL

Collaborative Antimicrobial Stewardship Program (ASP)

Intervention Type BEHAVIORAL

The collaborative ASP interventions will be implemented from October 1st, 2021 to September 30th, 2023 in all participating NICUs.

The collaborative ASP interventions include two levels of interventions that will be delivered at the NICU level: the NICU-targeted ASP program and collaborative quality improvement interventions to facilitate implementation of the ASP.

The core elements of the NICU-targeted ASP program include the establishment of ú ASP leader and team, development of the facility-specific antibiotic guidelines, checklist-led audit and feedback, and staff education.

The collaborative quality improvement interventions include data feedback and benchmarking, a potential 'better practice' list on neonatal antibiotic use, implementation using Plan-Do-Study-Act cycles and collaborative learning.

Interventions

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Collaborative Antimicrobial Stewardship Program (ASP)

The collaborative ASP interventions will be implemented from October 1st, 2021 to September 30th, 2023 in all participating NICUs.

The collaborative ASP interventions include two levels of interventions that will be delivered at the NICU level: the NICU-targeted ASP program and collaborative quality improvement interventions to facilitate implementation of the ASP.

The core elements of the NICU-targeted ASP program include the establishment of ú ASP leader and team, development of the facility-specific antibiotic guidelines, checklist-led audit and feedback, and staff education.

The collaborative quality improvement interventions include data feedback and benchmarking, a potential 'better practice' list on neonatal antibiotic use, implementation using Plan-Do-Study-Act cycles and collaborative learning.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* All infants born at ≤31+6 weeks' gestation and admitted to the participating NICUs between October 1st, 2019 and September 30th, 2023.
* The period from October 1st, 2019 to September 30th, 2021 will be used as the baseline period before ASP intervention. Clinical data of eligible infants in this period will be retrospectively collected from a previously established database of preterm infants.
* The ASP implementation will be initiated on October 1st, 2021. The period from October 1st, 2021 to September 31st, 2023 will be the ASP intervention period and data will be prospectively collected.

Exclusion Criteria

* Infants who are transferred to non-participating NICUs within 24 hours after birth.
Minimum Eligible Age

0 Days

Maximum Eligible Age

120 Days

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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China Medical Board

OTHER

Sponsor Role collaborator

Children's Hospital of Fudan University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Fujian Maternity and Child Health Hospital

Fuzhou, Fujian, China

Site Status RECRUITING

Quanzhou Women and Children's Hospital

Quanzhou, Fujian, China

Site Status RECRUITING

Gansu Provincial Maternity and Child Care Hospital

Lanzhou, Gansu, China

Site Status RECRUITING

Guangzhou Women and Children's Medical Center

Guangzhou, Guangdong, China

Site Status RECRUITING

Shenzhen Maternity and Child Health Care Hospital

Shenzhen, Guangdong, China

Site Status RECRUITING

Women and Children's Hospital of Guangxi Zhuang Autonomous Region

Nanning, Guangxi, China

Site Status RECRUITING

Guizhou Women and Children's Hospital/Guiyang Children's Hospital

Guiyang, Guizhou, China

Site Status RECRUITING

Henan Children's Hospital

Zhengzhou, Henan, China

Site Status RECRUITING

The Third Affiliated Hospital of Zhengzhou University

Zhengzhou, Henan, China

Site Status RECRUITING

Hunan Children's Hospital

Changsha, Hunan, China

Site Status RECRUITING

Children's Hospital of Nanjing Medical University

Nanjing, Jiangsu, China

Site Status RECRUITING

Nanjing Maternity and Child Health Care Hospital

Nanjing, Jiangsu, China

Site Status RECRUITING

Children's Hospital of Soochow University

Suzhou, Jiangsu, China

Site Status RECRUITING

Suzhou Municipal Hospital affiliated to Nanjing Medical University

Suzhou, Jiangsu, China

Site Status RECRUITING

The First Bethune Hospital of Jilin University

Changchun, Jilin, China

Site Status RECRUITING

General Hospital of Ningxia Medical University

Xining, Ningxia, China

Site Status RECRUITING

Northwest Women's and Children's Hospital

Xi'an, Shaanxi, China

Site Status RECRUITING

Shaanxi Provincial People's Hospital

Xi'an, Shaanxi, China

Site Status RECRUITING

Qingdao Women and Children's Hospital

Qingdao, Shandong, China

Site Status RECRUITING

The Affiliated Hospital of Qingdao University

Qingdao, Shandong, China

Site Status RECRUITING

Children' s Hospital of Fudan University

Shanghai, Shanghai Municipality, China

Site Status RECRUITING

Children's Hospital of Shanghai

Shanghai, Shanghai Municipality, China

Site Status RECRUITING

Tianjin Obstetrics & Gynecology Hospital

Tianjin, Tianjin Municipality, China

Site Status RECRUITING

People's Hospital of Xinjiang Uygur Autonomous Region

Ürümqi, Xinjiang, China

Site Status RECRUITING

The First Affiliated Hospital of Xinjiang Medical University

Ürümqi, Xinjiang, China

Site Status RECRUITING

First Affiliated Hospital of Kunming Medical University

Kunming, Yunnan, China

Site Status RECRUITING

Countries

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China

Central Contacts

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Siyuan Jiang, PhD

Role: CONTACT

8613761644971

Facility Contacts

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Changyi Yang

Role: primary

Dongmei Chen

Role: primary

Jingyun Shi

Role: primary

Huayan Zhang

Role: primary

Chuanzhong Yang

Role: primary

Qiufen Wei

Role: primary

Ling Liu

Role: primary

Wenqing Kang

Role: primary

Falin Xu

Role: primary

Xirong Gao

Role: primary

Rui Cheng

Role: primary

Shuping Han

Role: primary

Bin Sun

Role: primary

Zuming Yang

Role: primary

Hui Wu

Role: primary

Yinpin Qiu

Role: primary

Zhankui Li

Role: primary

Qin Zhang

Role: primary

Ruobing Shan

Role: primary

Hong Jiang

Role: primary

Siyuan Jiang, PhD

Role: primary

Xiaohui Gong

Role: primary

Xiuying Tian

Role: primary

Long Li

Role: primary

Mingxia Li

Role: primary

Kun Liang

Role: primary

Other Identifiers

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2021144

Identifier Type: -

Identifier Source: org_study_id

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