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INSPIRE Trial for Abdominal Infections

Not Applicable
Completed
Conditions
Abdominal (ABD) Infection
Registration Number
NCT05423743
Lead Sponsor
Harvard Pilgrim Health Care
Brief Summary

The INSPIRE Abdominal Infection Trial is a cluster-randomized controlled trial of HCA Healthcare hospitals comparing routine empiric antibiotic stewardship practices with real-time, precision medicine computerized physician order entry (CPOE) smart prompts providing the probability that a non-critically ill adult admitted with abdominal infection is infected with a resistant pathogen.

Note: enrolled "subjects" represent 102 individual HCA Healthcare hospitals that have been randomized into 92 clusters. Hospitals were grouped into the same randomization cluster if they shared campuses or antibiotic stewardship staff.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
198480
Inclusion Criteria
  1. HCA Healthcare hospitals admitting adults for abdominal infection
  2. Facility use of MEDITECH as their electronic health record system

Facility

Exclusion Criteria

Note: unit of randomization is the hospital, however the computerized physician order entry (CPOE) alert intervention will calculate risk estimates for adults age >=18 admitted to non-intensive care unit wards and who are ordered to receive extended-spectrum antibiotics for abdominal infection.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Primary Outcome Measures
NameTimeMethod
Extended-Spectrum Days of Antibacterial Therapy (ES-DOT) Per Empiric DayFirst 3 calendar days of hospitalization for each patient during the 12-month baseline and 12-month intervention periods

Days-of-Therapy is a standardized national measure for antibacterial use in hospitals that counts each different antibiotic administered on each calendar day as one day of therapy, regardless of doses given.

Extended-spectrum days-of-therapy per empiric day is defined as the summed number of different extended-spectrum antibiotics received per patient each calendar day, beginning at admission. If an admission is less than 3 days, only the number of days the patient is admitted will contribute to the numerator and denominator.

For example, 2 different extended-spectrum antibiotics administered at least once during each of the first 3 days would yield 6 days of extended-spectrum days-of-therapy.

Secondary Outcome Measures
NameTimeMethod
Vancomycin Days of Antibacterial Therapy Per Empiric DayFirst 3 calendar days of hospitalization for each patient during the 12-month baseline and 12-month intervention periods

Days-of-Therapy is a standardized national measure for antibacterial use in hospitals that counts each different antibiotic administered on each calendar day as one day of therapy, regardless of doses given.

Vancomycin days-of-therapy per empiric day is defined as the the number of days that vancomycin is received by a patient, averaged over the empiric period, and summed across all participants. If an admission is less than 3 days, only the number of days the patient is admitted will contribute to the numerator and denominator.

Antipseudomonal Antibiotic Days Of Therapy (ES-DOT) Per Empiric DayFirst 3 calendar days of hospitalization for each patient during the 12-month baseline and 12-month intervention periods

Days-of-Therapy is a standardized national measure for antibacterial use in hospitals that counts each different antibiotic administered on each calendar day as one day of therapy, regardless of doses given.

Antipseudomonal days-of-therapy per empiric day is defined as the summed number of different antipseudomonal antibiotics received per patient each calendar day, beginning at admission. If an admission is less than 3 days, only the number of days the patient is admitted will contribute to the numerator and denominator.

For example, 2 different antipseudomonal antibiotics administered at least once during each of the first 3 days would yield 6 days of antipseudomonal days-of-therapy.

Trial Locations

Locations (101)

Riverside Community Hospital

🇺🇸

Riverside, California, United States

Regional Medical Center of San Jose

🇺🇸

San Jose, California, United States

Good Samaritan Hospital

🇺🇸

San Jose, California, United States

Los Robles Hospital & Medical Center

🇺🇸

Thousand Oaks, California, United States

West Hills Hospital & Medical Center

🇺🇸

West Hills, California, United States

The Medical Center of Aurora

🇺🇸

Aurora, Colorado, United States

Swedish Medical Center

🇺🇸

Englewood, Colorado, United States

Sky Ridge Medical Center

🇺🇸

Lone Tree, Colorado, United States

North Suburban Medical Center

🇺🇸

Thornton, Colorado, United States

Blake Medical Center

🇺🇸

Bradenton, Florida, United States

Scroll for more (91 remaining)
Riverside Community Hospital
🇺🇸Riverside, California, United States

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