Emergencies Clinical Trial
Official title:
DetermInants of Antimicrobial Use aNd De-escalAtion in Critical Care (DIANA Study)
Appropriate initial antibiotic therapy is crucial in the treatment of severe infections in
patients with intensive care. Adequate spectrum and appropriate doses are the keys to
achieving the therapeutic goal. Despite broad consensus on the spectrum and timing of
antimicrobial therapy, antibiotic use varies according to various parameters including
choice, dose, method of administration, duration of antibiotic therapy and de-escalation. an
empirical attitude.
Therapeutic de-escalation is considered essential for the use of antibiotics and is now
clearly established by different consensus. However, routine de-escalation has recently been
questioned in a randomized, controlled study that did not demonstrate non-inferiority of
de-escalation with an increase in the number of days of antibiotic therapy associated with an
increased number of days. superinfection.
The components of the de-escalation described in the literature, are based on the reduction
of the number of antibiotics, the strict observance of the spectrum of the antibiotic, the
reduction of use of the antibiotic, the stopping of any inappropriate antibiotic treatment (
lack of in vitro activity).
De-escalation can be considered in different ways; there are significant variations between
hospitals, countries, teams. A large European multicenter cohort is needed.
The main objective of this study is to describe empiric antibiotic therapy in intensive care
and the modalities of de-escalation.
Appropriate initial antibiotic therapy is crucial in the treatment of severe infections in
patients with intensive care. Adequate spectrum and appropriate doses are the keys to
achieving the therapeutic goal. Despite broad consensus on the spectrum and timing of
antimicrobial therapy, antibiotic use varies according to various parameters including
choice, dose, method of administration, duration of antibiotic therapy and de-escalation. an
empirical attitude.
Therapeutic de-escalation is considered essential for the use of antibiotics and is now
clearly established by different consensus. However, routine de-escalation has recently been
questioned in a randomized, controlled study that did not demonstrate non-inferiority of
de-escalation with an increase in the number of days of antibiotic therapy associated with an
increased number of days. superinfection.
The components of the de-escalation described in the literature, are based on the reduction
of the number of antibiotics, the strict observance of the spectrum of the antibiotic, the
reduction of use of the antibiotic, the stopping of any inappropriate antibiotic treatment (
lack of in vitro activity).
De-escalation can be considered in different ways; there are significant variations between
hospitals, countries, teams. A large European multicenter cohort is needed.
The main objective of this study is to describe empiric antibiotic therapy in intensive care
and the modalities of de-escalation (rate of de-escalation, incidence of mortality, length of
stay in intensive care unit, relapse, rate of superinfection)
;
| Status | Clinical Trial | Phase | |
|---|---|---|---|
| Completed |
NCT05552989 -
Towards Better Preparedness for Future Catastrophes - Local Lessons-learned From COVID-19
|
||
| Not yet recruiting |
NCT04915690 -
Investigation on the Practice Status of Emergency Stuff
|
||
| Not yet recruiting |
NCT03424096 -
Primary Palliative Care Education, Training, and Technical Support for Emergency Medicine
|
N/A | |
| Completed |
NCT02534324 -
The Effect of Pre-discharge Blood Pressure of Patients With Asymptomatic Severe Hypertension in Emergency Department
|
N/A | |
| Completed |
NCT00991471 -
The Effect of an Physician-Nurse Supplementary Triage Assistance Team on Emergency Department Patient Wait Times
|
N/A | |
| Recruiting |
NCT03257319 -
Inhaled vs IV Opioid Dosing for the Initial Treatment of Severe Acute Pain in the Emergency Department
|
Phase 3 | |
| Recruiting |
NCT05005117 -
Laparoscopic Approach for Emergency Colon Resection
|
N/A | |
| Recruiting |
NCT03917368 -
Ultrasound Evaluation of the Jugular Venous Pulse (US-JVP)
|
N/A | |
| Completed |
NCT04601922 -
Qualitative Study of Long Term Cardiovascular Risk Prediction in the Emergency Department
|
||
| Recruiting |
NCT05497830 -
Machine Learning for Risk Stratification in the Emergency Department (MARS-ED)
|
N/A | |
| Active, not recruiting |
NCT06220916 -
The Greek Acute Dance Injuries Registry
|
||
| Recruiting |
NCT05543772 -
Evaluation of Blood Sampling From a Pre-existed Peripheral Intravenous Catheter Line
|
Phase 4 | |
| Recruiting |
NCT06072534 -
Evaluation of Effectiveness of Two Different Doses of Mivacurium in Rapid Sequence Intubation
|
N/A | |
| Not yet recruiting |
NCT05528211 -
Safety and Efficacy of Emergent TAVI in Patients With Severe AS
|
||
| Completed |
NCT05818215 -
Impact of the Qatar 2022 FIFA World Cup on PED Use and Misuse Patterns
|
||
| Recruiting |
NCT04615065 -
Acutelines: a Large Data-/Biobank of Acute and Emergency Medicine
|
||
| Active, not recruiting |
NCT05221697 -
Effect of an ML Electronic Alert Management System to Reduce the Use of ED Visits and Hospitalizations
|
N/A | |
| Active, not recruiting |
NCT04648449 -
Artificial Intelligence (AI) Support in Medical Emergency Calls
|
||
| Not yet recruiting |
NCT04431986 -
ER2 Frailty Levels and Incident Adverse Health Events in Older Community Dwellers
|
||
| Completed |
NCT05597059 -
The Diagnostic Value of the First Clinical Impression of Patients Presenting to the Emergency Department (PREKEYDIA)
|