Clinical Trials Logo
  1. Home
  2. Hospital-Acquired Pneumonia
  3. NCT04937075

Impact of Antimicrobial Stewardship on Outcomes of Patients With Hospital-acquired Pneumonia Due to Gram-negative Bacilli - A Before-after Study — ORACLE  

Hospital-acquired Pneumonia Clinical Trial

Official title:
Impact of Antimicrobial Stewardship on Outcomes of Patients With Hospital-acquired Pneumonia Due to Gram-negative Bacilli - A Before-after ORACLE Study

Clinical Trial Summary

Hospital-acquired pneumonia (HAP) is one of the most frequent complications and the main cause of antibiotics use in hospitalized patients, particularly in intensive care units (ICUs). The latest European and French recommendations for the management of HAP were published in 2017 and 2018. Gram-negative bacilli are frequently identified in this pneumonia. The experts discussed the issue of tailored-empiric antimicrobial therapy. Because delayed antimicrobial therapy is associated with poor outcomes, their conclusion was to reduce the time to deliver proper antimicrobial therapy, but to limit over-use of broad-spectrum molecules. Since delays in microbiological identification hinder the ability of clinicians to streamline therapy, rapid diagnostic with multiplex PCR, which decreases the time to organism identification by 2 days compared to conventional methods, is appealing, especially for gram-negative bacilli. The FilmArray® Lower Respiratory Tract Infection Panel is a rapid multiplex PCR which tests for the most frequently pathogens (18 bacteria including plenty of gram-negative bacilli +5 genes of resistance, and 9 viruses) involved in HAP. The FilmArray® Lower Respiratory Tract Infection (LRTI) Panel has a sensitivity and a specificity of 95% and 99% respectively and can be implemented in a personalized antimicrobial guidance to treat HAP due to gram-negative bacilli. The investigators hypothesized that a rapid multiplex PCR for guidance of empiric antimicrobial therapy, especially for gram-negative bacilli, reduces the time-to-proper antimicrobial therapy and reduces the risk of death of patients suffering of HAP. The investigators aim to assess the efficacy of an antimicrobial stewardship including the results of a rapid respiratory panel multiplex PCR for empiric antimicrobial guidance in patients with hospital-acquired pneumonia due to gram-negative bacilli. The investigators will use a before-after design to test the efficiency of an antimicrobial stewardship including a highly innovative intervention.

Clinical Trial Description

n/a

Study Design

Related Conditions & MeSH terms

Clinical Trial Details
NCT number NCT04937075
Study type Observational
Source Nantes University Hospital
Contact
Status Completed
Phase
Start date June 1, 2019
Completion date January 15, 2022
View Details
See also
  Status Clinical Trial Phase
Completed NCT01266863 - E Test Strips Applied to Bronchoalveolar Lavage for Suspicion of Hospital-acquired Pneumonia to Accelerate Antibiogram Analysis. N/A
Not yet recruiting NCT06168734 - Cefepime-taniborbactam vs Meropenem in Adults With VABP or Ventilated HABP Phase 3
Not yet recruiting NCT01940731 - Efficacy and Safety of Colistimethate Sodium Injection Vial to Treat Hospital-acquired Pneumonia in Adults Phase 2
Not yet recruiting NCT06028217 - Chinese Hospital Acquired Pneumonia Collaboration Network: Epidemiology, Diagnosis and Treatment
Completed NCT01561469 - Evaluation of Patients With Methicillin-Resistant Staphylococcus Aureus Hospital-Acquired Pneumonia Treated With Linezolid or Vancomycin N/A
Terminated NCT00543608 - Clinical Efficacy of Intravenous Iclaprim Versus Vancomycin in the Treatment of Hospital-Acquired, Ventilator-Associated, or Health-Care-Associated Pneumonia Phase 2
Enrolling by invitation NCT04055922 - Comparison of Solid Organ Transplant
Completed NCT04403971 - 0.12% Chlorhexidine Oral Care for the Prevention of Non-ventilator Hospital-acquired Pneumonia N/A
Completed NCT04774094 - Efficacy and Safety of Ceftazidime-Avibactam (CAZ-AVI) in Chinese Participants With HAP (Including VAP) Phase 4
Completed NCT05060718 - HOspital NEtwork STudy - Preparation for a Randomized Evaluation of Anti-Pneumonia Strategies
Active, not recruiting NCT05785442 - Use of Presepsin as a Marker for Immunotherapy Administration in Pneumonia Phase 2
Completed NCT04700202 - Identifying Risk Factors for Gram-negative Resistance for HAP/VAP in the Intensive Care Unit
Not yet recruiting NCT05418517 - Hospital Acquired Pneumonia in Temporary Tracheostomy
Recruiting NCT04381247 - Comprehensive Molecular Diagnosis and Management of Hospital- and Ventilator-associated Pneumonia in Norway
Recruiting NCT05483309 - Feasibility Study of Contemporary Diagnostics for Patients With Suspected Hospital-Acquired Pneumonia. N/A
Completed NCT03496220 - Effect of Angulus on Patient-elevation Compliance N/A
Not yet recruiting NCT05914584 - "Baricitinib for Treating Hospital-acquired Pneumonia in Critically Ill Patients With a Proinflammatory Phenotype. Phase 2/Phase 3
Completed NCT05663905 - Efficacy of Intravenous Amboxol Hydrochloride as an Adjunct Therapy for Severe Pneumonia in Critically Ill Patients Phase 4
Terminated NCT03361085 - Modular Prevention Bundle for Non-ventilator-associated Hospital-acquired Pneumonia (nvHAP) N/A
Completed NCT05624684 - Diagnostic Performance and Impact of a Multiplex PCR Pneumonia Panel in ICU Patients With Severe Pneumonia.