Infection Clinical Trial
Official title:
DetermInants of Antimicrobial Use aNd De-escalAtion in Critical Care (DIANA Study)
DetermInants of Antimicrobial use aNd de-escalAtion in critical care (DIANA study), is a multicenter, international, prospective, observational cohort study, aiming to describe the rate of de-escalation as well as the associated outcome and the empirical antibiotic therapy for infections at the intensive care unit.
Despite the consensus regarding spectrum and timing of antibiotic therapy, antimicrobial use
varies across ICUs; indeed there are important variations in choice, dosing, method of
administration, duration of antimicrobial therapy and de-escalation of empirical therapy.
DetermInants of Antimicrobial use aNd de-escalAtion in critical care (DIANA study), is a
multicenter, international, prospective, observational cohort study, aiming to describe the
rate of de-escalation as well as the associated outcome and the empirical antibiotic therapy
for infections at the intensive care unit.
Given the explorative nature of this study the required number of patients was not
calculated. The investigators aim to include 2000 patients in whom empirical antibiotics are
started. With an estimated de-escalation rate of 35%, an estimation to include 700 patients
in whom de-escalation is performed is made which would allow for a suitable multivariable
analysis.
For each participating center center data will be collected as detailed in an electronic
Center Report Form. This will be completed only once per center.
For each participating center data on 4 elements will be collected: ICU-related data,
microbiology laboratory practices, definition of de-escalation as used in the participating
center and local de-escalation practices, background resistance levels.
This is a prospective observational study in which patients will be included in the
participating centers during a 2-week period.
For each patient included in the study, data will be collected in an electronic Case Report
Form.
For each included patient data on 4 elements will be collected: patient data (demographics,
underlying and co-morbid conditions, patient characteristics on different time points),
infection data (clinical and microbiological), treatment data (antimicrobial therapy and
source control) and outcome data (28 day follow up period)
National coordinators:
National Coordinators will be appointed by the Steering Committee and will have a key role in
the conduction of the study in the individual countries as leaders of the project.
Ethics committee approval:
Ethics committee approval may vary from country to country. The national coordinator is
responsible for obtaining ethics committee approval if this is required on a national level
(or any procedure similar to this). Informed consent will be obtained from the subject or
nominated representative (where applicable). As this is an observational study some countries
and sites may waive the need for informed consent.
Data management:
All patient data will be collected anonymously and will be entered in an electronic data
capturing system. Data provided by the local investigators are primarily the property of the
ICU that collected the data. Local investigators shall have access to their data after they
have been entered in the central database.The servers of the system are hosted at True; True
has been certified by the Lloyd's Register Quality Assurance (LRQA) according to the
international information security norm ISO 27001:2013. True provides its services in
accordance with the NEN7510 norm for information security in healthcare.
Data control:
Local investigators may be contacted for queries in case of outliers, excessive missing
values and other reasons deemed relevant by the primary investigator.
Statistical analysis:
Statistical analysis will be performed by the primary investigators using a statistical
software program and assisted by expert statisticians when necessary.
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