Appropriateness of Intravenous Antibiotics Prescriptions at Hospital Discharge

NCT03173768 | Completed

• 1 other identifier: 3631
• Study Type: interventional
• Target: 173
• Locations: 1 country
• Sites: 1

Brief Summary

A quasi-experimental study was conducted among patients receiving care at the medicine units of the Maharaj Nakorn Chiang Mai Hospital to determine the appropriateness of intravenous antibiotics at hospital discharge with and without ID consultation.

Conditions

Anti-Infectives Adverse Reaction

Keywords

intravenous antibiotics; appropriateness; outpatient antimicrobial therapy

Outcome Measures

Primary Outcomes (1)

• The proportion of appropriateness of intravenous antibiotics prescriptions at hospital discharge between groups

  To calculate the number of antibiotic prescriptions at hospital discharge over the total number of prescriptions, comparing between pre-and post-intervention period.

  16 months

Secondary Outcomes (4)

• The costs of antibiotics for the course of treatment

  16 months

• Clinical improvement at 1 week

  1 week

• Readmission within 30 days, length of hospital stay

  30 days

• Length of hospital stay

  60 days

Study Arms (2)

pre-intervention period

NO INTERVENTION

The charts of patients who were prescribed intravenous antibiotics at hospital discharge were reviewed. Appropriateness of intravenous antibiotics was assessed by ID specialists.

post-intervention period

EXPERIMENTAL

The intervention is the charts of patients who were prescribed intravenous antibiotics at hospital discharge by the primary team were prospectively reviewed and intervened by ID team (ID specialist approval)

Procedure: ID specialist approval

Interventions

ID specialist approval PROCEDURE

Appropriateness of intravenous antibiotics ordered by the primary team was assessed by ID specialist. ID fellow modified the intravenous antibiotics ordered by the primary team if those intravenous antibiotics were judged as inappropriate by ID fellow as follows: 1) discontinue intravenous antibiotics (treatment was complete), 2) switch to oral antibiotics, 3) change intravenous antibiotics to cover isolated pathogens, 4) adjust the dose of intravenous antibiotics, and 5) change the duration of intravenous antibiotics. Finally, ID specialist retrospectively assessed the appropriateness of intravenous antibiotics at hospital discharge managed by ID fellow in post-intervention period.

post-intervention period

Eligibility Criteria

• Age: 15 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• All adult patients who met the following criteria were consecutively enrolled;
• age≥ 15 years old and
• had infections at any sites and received intravenous antibiotics.

You may not qualify if:

• \- They were evaluated by infectious diseases specialist for appropriate antibiotics during admission

Sponsors & Collaborators

• Chiang Mai University: lead

Study Sites (1)

Department of Medicine

Chiang Mai, 50200, Thailand

Location

Study Officials

• Romanee Chaiwarith, MD

  Maharaj Nakorn Chiang Mai Hospital

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: SEQUENTIAL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor

Study Record Dates

• First Submitted: April 3, 2017
• First Posted: June 2, 2017
• Study Start: November 1, 2015
• Primary Completion: February 28, 2017
• Study Completion: February 28, 2017
• Last Updated: June 5, 2017

Record last verified: 2017-06

Data Sharing

• IPD Sharing: Will not share

Locations

TH (1)