Impact of Implementation of Antimicrobial Stewardship Comprehensive Care Bundle Program on Ventilator Associated Pneumonia in Surgical Intensive Care Unit
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 25
- 主要终点
- change in ventilator associated pneumonia incidence
研究概览
简要总结
Antibiotic Stewardship Programs (ASPs) help clinicians improve the quality of patient care and improve patient safety through increased infection cure rates, reduced treatment failures; however, there are different techniques, with variable results, of its application including what is called ASPs bundle and there is a need to investigate the effectiveness of implementing a comprehensive care bundle program including the key components of ASPs and the key items of infection control measures, this program can be called Antimicrobial Stewardship Comprehensive Care Bundle Program (ASCCBP).
详细描述
Survey experimental study will be done in the first 6 months as regard antimicrobial drugs pattern and organism's sensitivity and resistance pattern in VAP patients.
In the next six months, clinical implementation of ASPs and infection control bundle will be applied on VAP patients. Then, in the later six months the investigators will study the outcome of VAP patients as regard:
- Amount of cost of antibiotics.
- Appropriates of antibiotic use (initiation, duration & time of discontinuation).
- Rate of resistance
- Clinical outcome, infection rate &length of stay.
Regular reports on antibiotic use and resistance will be admitted to relevant staff every one month. Also, audit and feedback about resistance and optimal prescribing will be applied every one month for ICU stuff as an open discussion.
The stewardship consulting team will include microbiologist with clinical experience in the field of antibiotic use and infection control. Stewardship team also will include the relevant ICU staff and an experienced clinical pharmacist.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Retrospective
入排标准
- 年龄范围
- 18 Years 至 70 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients, ≥18 years, who were intubated and mechanically ventilated for more than 48 hours in ICU and showing clinical criteria of VAP
排除标准
- •Patients on immunosuppressive drugs.
- •Patient with chronic lung disease, chronic liver disease& chronic renal disease.
- •Immunocompromised Patients.
- •Patients intubated and mechanical ventilated outside the ICU before admission.
- •Patients manifested clinically with picture suggestive of VAP but less than 48 hours on mechanical ventilation.
结局指标
主要结局
change in ventilator associated pneumonia incidence
时间窗: 18 months
After implementation of the Antimicrobial Stewardship Comprehensive Care Bundle Program (ASCCBP), the percentage of VAP incidence was measured to assess the effectiveness of the program.
change in antibiotic resistance pattern
时间窗: 18 months
measuring the change in sensitivity and resistance pattern of antibiotics used in ICU was done by assessing the change in the sputum culture and sensitivity results.
次要结局
- ventilation days(18 months)
- antibiotic cost(18 months)
研究者
Michael Adel Shaker
lecturer of anesthesia
Zagazig University