An Evaluation of a Antimicrobial Stewardship Recommendation Bundle for Staphylococcus Aureus Bloodstream Infections

Bacterial Infections Clinical Trial

Official title:

An Evaluation of a Antimicrobial Stewardship Recommendation Bundle for Staphylococcus Aureus Bloodstream Infections

Clinical Trial Details — Status: Active, not recruiting

Administrative data

• NCT number: NCT06211829
• Other study ID #: 016.PHA.2022.D
• Status: Active, not recruiting
• Start date: May 18, 2022
• Est. completion date: May 18, 2024

Study information

• Verified date: January 2024
• Source: Methodist Health System
• Contact: n/a
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

In July 2020, a bundle (Appendix C) was implemented at Methodist Dallas Medical Center where all patients with SAB were reviewed by the antimicrobial stewardship pharmacist (Monday - Friday from 0700 to 1500), a note outlining optimal interventions was written in the electronic medical record (EMR), and the recommendations were communicated to the primary team via secure messaging or telephone

Description:

Evaluation of the Staphylococcus aureus bloodstream infection(SAB)bundle recommendations will allow for determination of whether this intervention is impactful and warrants the resources currently devoted to it.

Recruitment information / eligibility

• Status: Active, not recruiting
• Enrollment: 208
• Est. completion date: May 18, 2024
• Est. primary completion date: May 18, 2024
• Gender: All
• Age group: 18 Years to 85 Years

Eligibility

Inclusion Criteria:

• 18 years of age SAB during hospital admission

Exclusion Criteria:

• Patients with a history of a prior SAB during the study period (only first occurrence included)
• Blood culture collected within 48hours of patient expiring or transitioning to hospice
• Patients discharged or left before culture results were available
• Patients transferred from an outside hospital

Related Conditions & MeSH terms

• Bacterial Infections
• Communicable Diseases
• Infections
• Sepsis

Locations

Country	Name	City	State
United States	Methodist Dallas Medical Center	Dallas	Texas

Sponsors (1)

Lead Sponsor	Collaborator
Methodist Health System

Country where clinical trial is conducted

United States, 

References & Publications (5)

Goto M, Schweizer ML, Vaughan-Sarrazin MS, Perencevich EN, Livorsi DJ, Diekema DJ, Richardson KK, Beck BF, Alexander B, Ohl ME. Association of Evidence-Based Care Processes With Mortality in Staphylococcus aureus Bacteremia at Veterans Health Administration Hospitals, 2003-2014. JAMA Intern Med. 2017 Oct 1;177(10):1489-1497. doi: 10.1001/jamainternmed.2017.3958. Erratum In: JAMA Intern Med. 2017 Oct 1;177(10):1544. — View Citation

Holland TL, Raad I, Boucher HW, Anderson DJ, Cosgrove SE, Aycock PS, Baddley JW, Chaftari AM, Chow SC, Chu VH, Carugati M, Cook P, Corey GR, Crowley AL, Daly J, Gu J, Hachem R, Horton J, Jenkins TC, Levine D, Miro JM, Pericas JM, Riska P, Rubin Z, Rupp ME, Schrank J Jr, Sims M, Wray D, Zervos M, Fowler VG Jr; Staphylococcal Bacteremia Investigators. Effect of Algorithm-Based Therapy vs Usual Care on Clinical Success and Serious Adverse Events in Patients with Staphylococcal Bacteremia: A Randomized Clinical Trial. JAMA. 2018 Sep 25;320(12):1249-1258. doi: 10.1001/jama.2018.13155. — View Citation

Perez-Rodriguez MT, Sousa A, Lopez-Cortes LE, Martinez-Lamas L, Val N, Baroja A, Nodar A, Vasallo F, Alvarez-Fernandez M, Crespo M, Rodriguez-Bano J. Moving beyond unsolicited consultation: additional impact of a structured intervention on mortality in Staphylococcus aureus bacteraemia. J Antimicrob Chemother. 2019 Apr 1;74(4):1101-1107. doi: 10.1093/jac/dky556. — View Citation

Smith JR, Frens JJ, Snider CB, Claeys KC. Impact of a pharmacist-driven care package on Staphylococcus aureus bacteremia management in a large community healthcare network: A propensity score-matched, quasi-experimental study. Diagn Microbiol Infect Dis. 2018 Jan;90(1):50-54. doi: 10.1016/j.diagmicrobio.2017.10.001. Epub 2017 Oct 7. — View Citation

Wenzler E, Wang F, Goff DA, Prier B, Mellett J, Mangino JE, Bauer KA. An Automated, Pharmacist-Driven Initiative Improves Quality of Care for Staphylococcus aureus Bacteremia. Clin Infect Dis. 2017 Jul 15;65(2):194-200. doi: 10.1093/cid/cix315. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	number of Staphylococcus Aureus blood stream infections (SAB)	Number of SAB occurring	12 weeks
Secondary	Number of In-hospital mortality	Number of In-hospital mortality	12 weeks
Secondary	number of times of bacteremia	time of bacteremia	12 weeks
Secondary	number of days of stay	duration of hospital stay	12 weeks
Secondary	number of times of readmission	Number time of readmission	12 weeks
Secondary	number of infection	Number of times the infection is occurring	12 weeks