ATBREFSURMED: Impact of Infectious Diseases Specialists on the Appropriateness of Antimicrobial Therapy in Surgical and Medical Wards
Study Details
Study Description
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:
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Control group: antibiotic prescriptions will be initiated and managed by the attending physicians
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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.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
N/A |
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Experimental: Infectious disease specialist advice Patients receiving the intervention (infectious disease specialist advice) |
Other: Infectious disease specialist advice
Indication, choice, dosing and duration of antimicrobial therapy
|
| No Intervention: Control Patients not receiving infectious disease specialist advice |
Outcome Measures
Primary Outcome Measures
- 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 Outcome Measures
- 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
Eligibility Criteria
Criteria
Inclusion Criteria:
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Adults
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Hospitalized in surgical or medical wards
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Receiving antimicrobial therapy for active infection or prolonged surgical prophylaxis
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Therapy prescribed by the attending ward physician
Exclusion Criteria:
- Patients receiving antimicrobial therapy not prescribed by the attending ward physician
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Henri Mondor University Hospital | Créteil | France | 94010 |
Sponsors and Collaborators
- Henri Mondor University Hospital
Investigators
- Principal Investigator: Philippe Lesprit, MD, Assistance Publique - Hôpitaux de Paris
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- PREQHOS 08023