A Cluster Randomized Controlled Trial Comparing Early and Late Carbapenems De-escalation in the Medicine Units, Maharaj Nakorn Chiang Mai Hospital
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 104
- 主要终点
- The rate of de-escalation within the first 24 hour
研究概览
简要总结
Early de-escalation of carbapenems can reduce unnecessary use of carbaepenems compared with late de-escalation without compromised clinical outcomes
详细描述
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.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Health Services Research
- 盲法
- None
入排标准
- 年龄范围
- 15 Years 至 —（Child, Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •All adult patients aged ≥ 15 years old
- •received carbapenems (meropenem and imipenem/cilastatin) empirically within 24-72 hours for the first time during admission
- •able to sign informed consent
排除标准
- •They were in the intensive care units, or had neutropenia (absolute neutrophil count < 1,000 cell/mm3)
研究组 & 干预措施
Early carbapenems de-escalation
De-escalation carbapenems within 24 hours or no later than 72 hours of prescription by Infectious disease specialist (early de-escalation).
干预措施: Early Carbapenem de-escalation (Other)
Late carbapenems de-escalation
De-escalation 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
结局指标
主要结局
The rate of de-escalation within the first 24 hour
时间窗: 24 hours
Compare the rate of de-escalation within the first 24 hour between arm 1 and arm 2
次要结局
- Mortality rate(90 days)
- Readmission within 30 days,(30 days)
- Costs of carbapenems(30 days)
研究者
Romanee Chaiwarith
Associate professor
Chiang Mai University