Clinical Trials Logo

Clinical Trial Details — Status: Not yet recruiting

Administrative data

NCT number NCT04976829
Other study ID # 2021PI072
Secondary ID
Status Not yet recruiting
Phase
First received
Last updated
Start date September 1, 2021
Est. completion date September 1, 2022

Study information

Verified date July 2021
Source Central Hospital, Nancy, France
Contact Arnaud Florentin, Dr
Phone +33383155293
Email a.florentin@chu-nancy.fr
Is FDA regulated No
Health authority
Study type Observational

Clinical Trial Summary

Antibiotic resistance is one of the most pressing health threats that mankind faces now and in the coming decades. Antibiotic resistance leads to longer hospital stays, higher medical costs and increased mortality. In order to tackle antibiotic resistance, a computerized-decision support system (CDSS) facilitating antibiotic stewardship and an electronic surveillance software (ESS) facilitating infection prevention and control activities will implement in our tertiary care university hospital. The investigators conduct a pragmatic, prospective, single-centre, before-after uncontrolled study with an interrupted time-series analysis 12 months before and 12 months after the introduction of the CDSS for antibiotic stewardship (APSS) and ESS for infection surveillance (ZINC). APSS and ZINC will assist respectively the antibiotic stewardship and the infection prevention and control teams of Nancy University Hospital (France). The investigators will evaluate the impact of the CDSS/ESS on the antibiotic use in adult (≥ 18 years) inpatients (hospitalised ≥ 48h). The primary outcome is the prescription rate by all healthcare professionals from the hospital of all systemic antibiotics expressed in defined daily doses/1 000 patients/month. Concurrently, the investigators will assess the safety of the intervention, its impact on the appropriateness of antibiotic prescriptions and on additional precautions (isolation precautions) as recommended in guidelines, and on bacterial epidemiology (multidrug-resistant bacteria and Clostridioides difficile infections) in the hospital. Finally, the investigators will evaluate the users' satisfaction and the cost of this intervention from the hospital perspective.


Recruitment information / eligibility

Status Not yet recruiting
Enrollment 100000
Est. completion date September 1, 2022
Est. primary completion date September 1, 2022
Accepts healthy volunteers No
Gender All
Age group 18 Years and older
Eligibility Inclusion Criteria: - All inpatients = 18 years and hospitalised = 48h in Nancy University Hospital Exclusion Criteria: - The paediatric and gynaeco-obstetric departments

Study Design


Intervention

Device:
Antibiotic stewardship and healthcare-associated infections surveillance assisted by computer
Implementation - in our tertiary care university hospital - of a computerized-decision support system (CDSS) facilitating antibiotic stewardship and of an electronic surveillance software (ESS) facilitating infection prevention and control activities

Locations

Country Name City State
n/a

Sponsors (1)

Lead Sponsor Collaborator
Central Hospital, Nancy, France

Outcome

Type Measure Description Time frame Safety issue
Primary Prescription rate of all systemic antibiotics The prescription rate by all healthcare professionals from the Nancy University Hospital of all systemic antibiotics (J01 code according to the Anatomical Therapeutic Chemical - ATC - 2017 classification) expressed in DDDs/1 000 patients/month. Calculated monthly during a 12-month before and 12-month after period
Secondary All-cause intra-hospital mortality rate All causes of death/1 000 inpatients/month Calculated monthly during a 12-month before and 12-month after period
Secondary Average length of stay Total length of stay for each inpatient/number of stays/month Calculated monthly during a 12-month before and 12-month after period
Secondary Incidence of healthcare associated infections New cases of HCAI/ number of inpatients/month Calculated monthly during a 12-month before and 12-month after period
Secondary Use of overall antibiotics and by therapeutic classes DDDs/1 000 patients/month Calculated monthly during a 12-month before and 12-month after period
Secondary Proportion of the antibiotic prescriptions compliant with guidelines Number of antibiotic prescriptions compliant with guidelines/number of antibiotic prescriptions evaluated Calculated monthly during a 12-month before and 12-month after period
Secondary Proportion of the additional precaution prescriptions compliant with hospital recommendations Number of additional precaution prescriptions compliant with hospital recommendations/number of additional precaution prescriptions evaluated Calculated monthly during a 12-month before and 12-month after period
Secondary Proportion of C. difficile infections Number of stays with C. difficile infections/number of stays with antibiotic treatment/month Calculated monthly during a 12-month before and 12-month after period
Secondary Proportion of multidrug resistant bacteria identification Number of stays with MDRB identification by bacterial sample done after 48h of hospitalization/number of stays with identification of bacterial isolates/month Calculated monthly during a 12-month before and 12-month after period
Secondary Hospital costs Costs of antibiotics (costs (in €) of all oral and intravenous antibiotics delivered by hospital pharmacy/month)
Average cost of hospital stays (costs (in €) of hospital stays for each inpatient/number of stays/month)
Costs of the implementation of the CDSS/ESS and of the purchased equipment (costs (in €) of installation and maintenance of the CDSS/ESS after 12 months of implementation)
During the 12-month after period
Secondary Users' satisfaction and acceptability Satisfaction (qualitative study after 6 months of use)
Proportion of APSS' alerts accepted by the AMS team (number of APSS' alerts accepted by the AMS team/number of alerts generated by APSS/month)
Proportion of AMS team's recommendations accepted by prescribers (number of AMS team's recommendations accepted by prescribers/number of recommendations given by the AMS team to prescribers/month)
During the 12-month after period
See also
  Status Clinical Trial Phase
Recruiting NCT05589727 - Application of Ventilator-Associated Events (VAE) in Ventilator-Associated Pneumonia (VAP) Notified in Brazil
Completed NCT04873557 - Copper Use as Protection Against Antimicrobial Resistance in the ICU N/A
Completed NCT03843021 - Ventricular Assist Device (VAD) Infection Prevention Survey
Recruiting NCT04579094 - Prevalence and Risk Factors for the Carriage of Bacteria and Clostridioid in Elderly Dependent Persons
Recruiting NCT04192435 - Tranexamic Acid to Reduce Infection After Gastrointestinal Surgery Phase 4
Recruiting NCT06216080 - Dynamic Full-Field Optical Coherence Tomography for Structural and Microbiological Characterization of Central Venous Catheter-deposited Biofilm in Critically Ill Patients
Enrolling by invitation NCT03924934 - Community-associated Highly-Resistant Enterobacterales
Recruiting NCT06379139 - Dynamic Full-field Optical Coherence Tomography for Structural and Microbiological Characterization of Endotracheal Tube Biofilm in Critically Ill Patients
Recruiting NCT06155747 - Transmission and Acquisition of Nontuberculous Mycobacteria Outbreak Investigation (TrANsMIt)
Completed NCT03349268 - Pulsed UV Xenon Disinfection to Prevent Resistant Healthcare Associated Infection N/A
Completed NCT04053257 - Effect of Video Camera Monitoring Feedback on Hand Hygiene Compliance and Infections in NICU N/A
Not yet recruiting NCT03189043 - Controlled Crossover Study of AIONX Antimicrobial Surface for the Prevention of Healthcare-associated Infections Phase 2
Completed NCT05797818 - Red Light Photobiomodulation and Topical Disinfectants Phase 1/Phase 2
Terminated NCT03361085 - Modular Prevention Bundle for Non-ventilator-associated Hospital-acquired Pneumonia (nvHAP) N/A
Completed NCT04770597 - Monitors to Improve Indoor Carbon Dioxide (CO2) Concentrations in the Hospital N/A
Recruiting NCT05612672 - Evaluation of GeoHAI Implementation N/A
Completed NCT02605499 - Ultra Violet-C Light Evaluation as an Adjunct to Removing Multi-Drug Resistant Organisms (UVCLEAR-MDRO) N/A
Completed NCT04676581 - Risk Benefit Ratio of Hirudotherapy: Retrospective Single-center Study of 37 Cases Over a Period of 9 Years
Recruiting NCT05979545 - EaRly impAct theraPy With Ceftazidime-avibactam Via rapID Diagnostics Phase 4
Active, not recruiting NCT04312243 - NO Prevention of COVID-19 for Healthcare Providers Phase 2