Carbapenems De-escalation as Antimicrobial Stewardship
- Conditions
- Anti-Bacterial Agents
- Interventions
- Other: Early Carbapenem de-escalation
- Registration Number
- NCT03114358
- Lead Sponsor
- Chiang Mai University
- Brief Summary
Early de-escalation of carbapenems can reduce unnecessary use of carbaepenems compared with late de-escalation without compromised clinical outcomes
- Detailed Description
A cluster randomized control trial was conducted among patients receiving care at the medicine units of the Maharaj Nakorn Chiang Mai Hospital.
Patients were randomly assigned into 2 groups. The standard group followed the hospital policy in which carbapenems were evaluated by ID specialist at 72 hours of admission (late de-escalation). De-escalation may occurred earlier depends upon the decision of the primary care team. The intervention group is de-escalation carbapenems early within 24 hours or no later than 72 hours of prescription by ID specialist (early de-escalation).
Clinical outcomes included rate of de-escalation within the first 24 hour, the mortality rate, and other clinical outcomes.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 104
Not provided
Not provided
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Early carbapenems de-escalation Early Carbapenem de-escalation De-escalation carbapenems within 24 hours or no later than 72 hours of prescription by Infectious disease specialist (early de-escalation).
- Primary Outcome Measures
Name Time Method The rate of de-escalation within the first 24 hour 24 hours Compare the rate of de-escalation within the first 24 hour between arm 1 and arm 2
- Secondary Outcome Measures
Name Time Method Mortality rate 90 days Compare the mortality rate between 2 groups
Readmission within 30 days, 30 days Compare the rate of readmission within 30 days between 2 groups
Costs of carbapenems 30 days Compare the cost of carbapenem prescription between 2 groups