Antimicrobial Stewardship Program and Ventilator Associated Pneumonia

Zagazig University

Status: Completed

Conditions: Ventilator Associated Pneumonia

Treatments: Other: implementation of antimicrobial stewardship comprehensive care bundle program on ventilator associated pneumonia patients

Study type: Observational

Funder types: Other

Identifiers

NCT04097899

2143/11-5-2015

Details and patient eligibility

About

Antibiotic Stewardship Programs (ASPs) help clinicians improve the quality of patient care and improve patient safety through increased infection cure rates, reduced treatment failures; however, there are different techniques, with variable results, of its application including what is called ASPs bundle and there is a need to investigate the effectiveness of implementing a comprehensive care bundle program including the key components of ASPs and the key items of infection control measures, this program can be called Antimicrobial Stewardship Comprehensive Care Bundle Program (ASCCBP).

Full description

Survey experimental study will be done in the first 6 months as regard antimicrobial drugs pattern and organism's sensitivity and resistance pattern in VAP patients.

In the next six months, clinical implementation of ASPs and infection control bundle will be applied on VAP patients. Then, in the later six months the investigators will study the outcome of VAP patients as regard:

• Amount of cost of antibiotics.
• Appropriates of antibiotic use (initiation, duration & time of discontinuation).
• Rate of resistance
• Clinical outcome, infection rate &length of stay.

Regular reports on antibiotic use and resistance will be admitted to relevant staff every one month. Also, audit and feedback about resistance and optimal prescribing will be applied every one month for ICU stuff as an open discussion.

The stewardship consulting team will include microbiologist with clinical experience in the field of antibiotic use and infection control. Stewardship team also will include the relevant ICU staff and an experienced clinical pharmacist.

Enrollment: 25 patients

Sex: All

Ages: 18 to 70 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patients, ≥18 years, who were intubated and mechanically ventilated for more than 48 hours in ICU and showing clinical criteria of VAP

Exclusion criteria

• Patients on immunosuppressive drugs.
• Patient with chronic lung disease, chronic liver disease& chronic renal disease.
• Immunocompromised Patients.
• Patients intubated and mechanical ventilated outside the ICU before admission.
• Patients manifested clinically with picture suggestive of VAP but less than 48 hours on mechanical ventilation.

Trial design

25 participants in 2 patient groups

Group A in preimplementation phase

Description:

Patient and antibiotic related data were collected to calculate and define; ventilator associated pneumonia incidence, mean ventilation days and mean length of stay, antibiotic selection, antibiotic cost, antibiotic susceptibility pattern, antibiotic consumption.

Group B in postimplementation phase

Description:

The appropriateness of antibiotic use (selection, initiation, duration \& time of discontinuation) before and after implementing the educational program was compared, calculation of the change in the ventilator associated pneumonia incidence \& length of ICU stay, calculation of the change in the rate of antibiotic resistance and calculation of the cost change of antibiotics used after implementing the educational program.

Treatment:

Other: implementation of antimicrobial stewardship comprehensive care bundle program on ventilator associated pneumonia patients