Errors in Prescription Antibiotics in Ventilator-associated Pneumonia

Pneumonia Clinical Trial

Official title:

Determination of Errors in Prescription Antibiotics in Ventilator-associated Pneumonia in Unit of Intensive Care of Clinical Hospital of Federal University of Uberlandia - Brazil

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT02074033
• Other study ID #: 30121978
• Status: Recruiting
• Phase: N/A
• First received: February 23, 2014
• Last updated: March 26, 2014
• Start date: March 2014
• Est. completion date: October 2014

Study information

• Verified date: March 2014
• Source: Federal University of Uberlandia
• Contact: Ana Carolina Souza Oliveira
• Phone: 055343182150
• Email: acsouzao[@]yahoo.com.br
• Is FDA regulated: No
• Health authority: Brazil: National Committee of Ethics in Research
• Study type: Observational

Clinical Trial Summary

The infection is a major risk to hospitalized patients, especially those admitted to the Intensive Care Unit (ICU) and an unfavorable factor in the outcome of critically ill patients, increasing costs and prolonging hospitalization hospitalar. The ventilator-associated pneumonia (PAV) is considered the most prevalent nosocomial infection in the ICU, occurring in 9% to 68% of patients with prosthetic ventilatória.Due to the high rate of PAV and mortality related to it, is very important both prescription and administration of antibiotics correctly, as deescalation or escalation according the result of cultures.Therefore, the objectives of this study is assess if whether the antibiotic prescribed of ventilator-associated pneumonia following the orientation of literature. Will also be assessed the rate of PAV in patients critically ill adults, the main microorganisms responsible by PAV and determining antimicrobial susceptibility.

Description:

In patients who had a diagnosis of ventilator-associated pneumonia by asssistente physician will be assessed initially prescribed antibiotics empirically and what conduct adopted after culture results.

We will be examined whether the antibiotic prescribed following the orientation of literature, considering the dose, interval between doses, dose adjustment for renal failure infusion time, treatment time and conduct after the culture results (deescalation, escalation or maintenance of antimicrobial initially prescribed ) . The deescalation consists of discontinuing the use of antimicrobial or antibiotic change to another with lower coverage and spectrum is performed, escalation occurs when adding a new antibiotic or antibiotic to change the coverage of other larger spectrum after culture results .

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 130
• Est. completion date: October 2014
• Est. primary completion date: April 2014
• Accepts healthy volunteers: No
• Gender: Both
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Be 18 years of age;

• Having the diagnosis of ventilator-associated pneumonia.

Exclusion Criteria:

• Be under 18 years of age;

Study Design

Time Perspective: Retrospective

Related Conditions & MeSH terms

• Pneumonia
• Pneumonia, Ventilator-Associated

Locations

Country	Name	City	State
Brazil	Ana Carolina Souza Oliveira	Uberlândia	Minas Gerais

Sponsors (1)

Lead Sponsor	Collaborator
Federal University of Uberlandia

Country where clinical trial is conducted

Brazil, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Determination of Errors in Prescription Antibiotics in Ventilator-associated Pneumonia in Unit of Intensive Care of Clinical Hospital of Federal University of Uberlandia - Brazil		six months	No

External Links

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•   ANGUS, D.C.et al. Epidemiology of severe sepsis in the United States: analysis of incidence, outcome and associa¬ted costs of care. Crit Care Med, New York, v.29, n.7, p.1303-1310, Jul 2001.
•   BURKE, J.P. Infection control- a problem for patient safety. N Engl J Med, Melbourn, v.348, n.7, p. 651-656, Feb 2003.
•   CAMARGO, L. F. A. et al. Ventilator associated pneumonia: comparison between quantitative and qualitative cultures of tracheal aspirates. Critical Care Medicine, New York, v.8, n.6, p. 422-430, Dec 2004.
•   EACHEMPATI, S.R. et al. Does de-escalation of antibiotic therapy for ventilator-associated pneumonia affect the likelihood of recurrent pneumonia or mortality in critically ill surgical patients? J Trauma, Baltimore, v.66, n.5, p.1343-1348, May 2009.
•   ERBAY, A., BODUR, H., AKINCI, E., ÇOLPAN, A. Evaluation of antibiotic use in intensive care units of a tertiary care hospital in Turkey. Journal of Hospital Infection, New York , v.59, p.53-61, Jan 2005.
•   GOMES SILVA, B.N. et al. De-escalation of antimicrobial treatment for adults with sepsis, severe sepsis or septic shock. Cochrane Database Syst Rev, Oxford,v.8, n.12, CD007934, Dec 2010.
•   Guidelines for the Management of Adults with Hospital-acquired, Ventilator-associated, and Healthcare-associated Pneumonia. American Journal of Respiratory and Critical Care Medicine, New
•   HEENEN, S., JACOBS, F., VINCENT,J-P. Antibiotic strategies in severe nosocomial sepsis: Why do we not de-escalate more often? Crit Care Med, New York, v.40, n.5, p.1404-1409, May 2012 .
•   RELLO, J. et al. De-escalation therapy in ventilator associated pneumonia. Crit Care Med , New York, v.32, n.11, p.2183-2190, Nov 2004.
•   SAFDAR, N.; CRNICH, C.J.; MAKI, D.G. The Pathogenesis of Ventilator-Associated Pneumonia: Its Relevance to Developing Effective Strategies for Prevention. Respiratory Care, Philadelphia, v.50, n.6, p.725-739, Jun 2005.
•   WAELE, J.J.D.et al. De-escalation after empirical meropenem treatment in the intensive care unit: Fiction or reality? Journal of Critical Care, Orlando, v.25, n.4, p.641-646, Jan 2010.