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临床试验/NCT02650518
NCT02650518Unknown2 期

Controlling Antimicrobial Use Through Reducing Unnecessary Treatment of Catheter Associated Urinary Tract Infections (CARCUTI)

National University Hospital, Singapore6 个研究点 分布在 1 个国家目标入组 500 人开始时间: 2015年12月最近更新:
适应症

试验速览

阶段
2 期
入组人数
500
试验地点
6
主要终点
Resolution

研究概览

简要总结

Hypothesis: A short course (3-5 days) of antibiotic therapy (experimental arm) is as safe and effective as a long course of antibiotic therapy for the treatment of catheter-associated urinary tract infections.

研究设计

研究类型
Interventional
分配方式
Randomized
干预模型
Parallel
主要目的
Treatment
盲法
None

入排标准

年龄范围
21 Years 至 —(Adult, Older Adult)
性别
All
接受健康志愿者

入选标准

  • Inpatients ≥ 21 years old.
  • Presence of indwelling urinary catheter at the time of urine culture for ≥2days.
  • Fever >38°C.
  • A urine specimen sent to the hospital microbiological laboratory for culture.
  • An antibiotic order for presumed symptomatic catheter associated urinary tract infection.

排除标准

  • Persistent fever >38°C for more than 24 hours, or any fever >38.9°C.
  • Haemodynamic instability, defined as:
  • Requirement for intravenous vasopressor agents
  • Systolic blood pressure <90 mmHg
  • Acute hypotensive event with drop in systolic blood pressure of >30 mmHg or diastolic blood pressure of >20 mmHg
  • The following laboratory values within the previous 48 hours (if available):
  • White blood cell count>15 or <4 x10^9/L.
  • Procalcitonin>0.25ug/mL
  • C Reactive Protein >100mg/mL
  • An increase in the serum creatinine of more than 50% from baseline
  • New requirement for oxygen supplement.
  • Current admission to a high dependency unit or ICU.
  • Radiological evidence of an upper urinary tract infection
  • Flank pain or tenderness, suggesting an upper urinary tract infection
  • Urologic surgical procedure within the previous 72 hours
  • Known structural genitourinary abnormalities including:
  • Nephrostomy tubes
  • Tumours of the urinary tract
  • Ureteric stenting
  • Ureteric strictures
  • Urolithiasis
  • Bloodstream or other significant infection suspected at any site other than the catheterized urinary tract.
  • Received antibiotics for more than 48 hours prior to randomization.
  • Positive urinary culture with organism resistant to all the investigational antibiotics in the week prior to randomisation.
  • Hypersensitivity to ciprofloxacin, cotrimoxazole and amoxicillin-clavulanate.

结局指标

主要结局

Resolution

时间窗: Day 14 post-randomisation

Resolution of signs and symptoms of CAUTI

次要结局

  • Admission to high dependency or intensive care units(14 days post-randomization)
  • Secondary Infections(3 months post-randomization)
  • Recurrent Urinary Tract Infections(3 months and 1 year post-randomization)
  • Urologic surgery or procedure(1 year post-randomization)
  • Antimicrobial use and duration(1 month post-randomization)
  • Colonization or infection by antibiotic-resistant organisms(30 days post-randomization)
  • Short-Term Resolution(day 3 and day 7 post-randomisation)
  • Recurrence of fever or symptoms(7, 14 and 30 days post randomization)
  • Haemodynamic instability(day 14 post randomization)
  • Length of hospitalization(30 days post-randomization)
  • Re-admission(Day 30 post-randomization)

研究者

申办方类型
Other
责任方
Sponsor

研究点 (6)

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