Antimicrobial Stewardship Program and Ventilator Associated Pneumonia
- Conditions
- Ventilator Associated Pneumonia
- Interventions
- Other: implementation of antimicrobial stewardship comprehensive care bundle program on ventilator associated pneumonia patients
- Registration Number
- NCT04097899
- Lead Sponsor
- Zagazig University
- Brief Summary
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).
- Detailed Description
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.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 25
• Patients, ≥18 years, who were intubated and mechanically ventilated for more than 48 hours in ICU and showing clinical criteria of VAP
- 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.
Study & Design
- Study Type
- OBSERVATIONAL
- Study Design
- Not specified
- Arm && Interventions
Group Intervention Description Group B in postimplementation phase implementation of antimicrobial stewardship comprehensive care bundle program on ventilator associated pneumonia patients The appropriateness of antibiotic use (selection, initiation, duration \& time of discontinuation) before and after implementing the educational program was compared, calculation of the change in the ventilator associated pneumonia incidence \& length of ICU stay, calculation of the change in the rate of antibiotic resistance and calculation of the cost change of antibiotics used after implementing the educational program.
- Primary Outcome Measures
Name Time Method change in ventilator associated pneumonia incidence 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 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.
- Secondary Outcome Measures
Name Time Method ventilation days 18 months Days of mechanical ventilation of each patient were measured to calculate the difference before and after implementation of the program.
antibiotic cost 18 months costs of antibiotics by Egyptian pounds were calculated to assess the effectiveness of the program