Improving Antimicrobial Prescribing Practices in the Neonatal Intensive Care Unit
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 6,184
- 试验地点
- 6
- 主要终点
- Overall Antimicrobial Use measured as days of therapy per 100 patient-days
研究概览
简要总结
To determine if 3 randomly assigned bundles of stewardship interventions would reduce overall and inappropriate antimicrobial use in the neonatal intensive care unit (NICU), a pre-post study was performed in 4 NICUs.
详细描述
Antimicrobial stewardship can improve the safety and quality of healthcare, reduce antimicrobial resistance, and reduce healthcare costs. However, the optimal strategies for the NICU population are unknown and few studies have evaluated the impact of stewardship in this population. To determine if 3 randomly assigned bundles of stewardship interventions would reduce overall and inappropriate antimicrobial use in the NICU. The investigators hypothesized that the bundle using all three interdisciplinary antimicrobial stewardship strategies (education, computer decision support and prescriber audit and feedback) would more effectively reduce overall and inappropriate antimicrobial use compared to usual care. A pre-post intervention study (one baseline year without interventions - May 1, 2009 - April 30, 2010, followed by two years of interventions - May 1, 2010 - April 30, 2012) was performed in 4 academically affiliated, level III NICUs. The sites were randomly assigned to usual care, one intervention, two interventions, or three interventions.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Prevention
- 盲法
- None
入排标准
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •infants admitted to study NICUs <7 days of age who remained hospitalized 4 days or more days
排除标准
- •Infants admitted to study NICUs 7 days of age and older who were hospitalized less than 4 days
结局指标
主要结局
Overall Antimicrobial Use measured as days of therapy per 100 patient-days
时间窗: Through study completion for 2 years
The indications for initiation of intravenous antimicrobials were categorized as initiation of empiric therapy (antibiotics started prior to culture results), definitive therapy (culture results available prior to initiation of antibiotics), or prophylaxis (e.g., antibiotics for postoperative prophylaxis).
次要结局
- Length of therapy per 100 patient-days(Through study completion for 2 years)
- Inappropriate Antimicrobial Use(Through study completion for 2 years)
- Number of infants initiated on ineffective empiric therapy(Through study completion for 2 years)
- Proportion of infants treated for culture negative late onset sepsis(Through study completion for 2 years)
研究者
Lisa Saiman
Professor of Pediatrics
Columbia University