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Clinical Trials/NCT02127528
NCT02127528
Unknown
N/A

Empiric Antibiotic Therapy for Ventilator-acquired Pneumonia With Gram-negative Bacilli in Intensive Care: Pharmacodynamic Evaluation and Impact.

Assistance Publique - Hôpitaux de Paris1 site in 1 country500 target enrollmentMay 2014

Overview

Phase
N/A
Intervention
Not specified
Conditions
Ventilator-associated Pneumonia
Sponsor
Assistance Publique - Hôpitaux de Paris
Enrollment
500
Locations
1
Primary Endpoint
adequate antibiotics
Last Updated
10 years ago

Overview

Brief Summary

this study aims to verify the adequacy of doses of antibiotics prescribed in clinical practice for the treatment of ventilated acquired pneumonia (VAP) in the intensive care unit (ICU) with the pharmacodynamic efficacy criteria considered relevant literature. The impact of these pharmacodynamic parameters on the clinical and microbiological VAP will be evaluated.

Registry
clinicaltrials.gov
Start Date
May 2014
End Date
December 2016
Last Updated
10 years ago
Study Type
Observational
Sex
All

Investigators

Responsible Party
Sponsor

Eligibility Criteria

Inclusion Criteria

  • Use of mechanical ventilation for more than 48 hours
  • Clinical suspicion of ventilation-acquired pneumonia (VAP) defined by new radiological persisting infiltrate (or ARDS) AND one of the following features:
  • purulent tracheal aspirates OR temperature ≥ 38.3°C OR leukocytosis\> 10 giga/L
  • High risk of multidrug-resistant bacteria, defined as either at least 6 days of mechanical ventilation OR antibiotic treatment in the previous 15 days
  • Implementation of a prior distal respiratory sample for microbiological diagnosis by bronchoalveolar lavage (BAL) OR distal sampling by protected catheter (PDP)
  • Age ≥ 18 years
  • Implementing a medical examination
  • Obtain the written consent of the patient, one of its relatives or trusted person previously designated or emergency clause.

Exclusion Criteria

  • Pregnant woman
  • Expected death within 72 hours of diagnosis of VAP patient
  • No affiliation to a social security scheme (beneficiary or legal)
  • Contraindication to one of classes of molecules used antibiotics (β-lactam / Fluoroquinolones / Aminoglycosides), contained in the Summary of Product Characteristics for authorization on the market.

Outcomes

Primary Outcomes

adequate antibiotics

Time Frame: 28 days

proportion of patients for whom the pharmacodynamic target defined a priori according to data from the literature is reached for each antibiotic anti Gram-negative bacillus used empirically activity (including β-lactams, fluoroquinolones and aminoglycosides)

Secondary Outcomes

  • Bacterial species(28 days)
  • Number of days alive without mechanical ventilation(28 days)
  • Clinical recovery(28 days)
  • Score of organ failure (SOFA)(8 days)
  • Death(28 days)
  • Distribution of the main pharmacodynamic parameters(28 days)
  • Eradication of gram negative bacilli responsible for VAP(28 days)

Study Sites (1)

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