Impact of Infectious Diseases Specialists on the Appropriateness of Antimicrobial Therapy in Surgical and Medical Wards: a Multicenter Randomized Controlled Trial.
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Patients Receiving Antimicrobial Therapy
- Sponsor
- Henri Mondor University Hospital
- Enrollment
- 264
- Locations
- 1
- Primary Endpoint
- Appropriateness of antimicrobial therapy
- Status
- Completed
- Last Updated
- 11 years ago
Overview
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:
- Control group: antibiotic prescriptions will be initiated and managed by the attending physicians
- 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.
Investigators
Philippe LESPRIT
Dr Philippe LESPRIT
Henri Mondor University Hospital
Eligibility Criteria
Inclusion Criteria
- •Hospitalized in surgical or medical wards
- •Receiving antimicrobial therapy for active infection or prolonged surgical prophylaxis
- •Therapy prescribed by the attending ward physician
Exclusion Criteria
- •Patients receiving antimicrobial therapy not prescribed by the attending ward physician
Outcomes
Primary Outcomes
Appropriateness of antimicrobial therapy
Time Frame: 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 Outcomes
- Antibiotic exposure(14 days)
- Clinical impact(Between days 7 and 10 after starting antimicrobial therapy)