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Does a Safety Difference Exist Between IV Push and IV Piggyback Antibiotics? (IVP-ABX)

U

University Medical Center of Southern Nevada

Status

Unknown

Conditions

Infection

Treatments

Device: Syringe IV Push over 2-3 minutes
Device: Piggyback over 30 minutes

Study type

Interventional

Funder types

Other

Identifiers

NCT03360617
UMC-2017-100

Details and patient eligibility

About

This study compares whether or not a safety difference exists between delivering antibiotics via IV push or IV piggyback method.

Full description

This study compares whether or not a safety difference exists between delivering antibiotics via the IV push or IV piggyback method. It will be a single center, prospective, double-blinded, double-dummy, randomized controlled trial on a convenience sample of patients presenting to the ED receiving select beta-lactam antibiotics. Patients will be randomized to IV push antibiotic plus IV piggyback placebo or IV push placebo plus IV piggyback antibiotic. Patients will only be enrolled when a pharmacist who is familiar with the study is available to prepare medications. Treatment group assignment will be predetermined using an Excel random number generator. An investigator will conduct an informed consent with the patient. Only the pharmacist will have access to the randomization records and will not reveal the randomization until the end of the study. If the patient consents to the study, a pharmacist involved in the study will prepare the IV push syringe and IV piggyback. The IV push syringe and IV piggyback will be prepared in a manner that makes the contents blinded. Preparation of the IV push syringe and IV piggyback are standardized. The syringe and piggyback will be handed to the nurse for administration. The IV push antibiotic will be administered over 2-3 minutes and the IV piggyback antibiotic will be administered over 30 minutes. The IV push and IV piggyback will be administered at the same time. A research assistant will conduct surveys with the patient at the start of administration and every 15 minutes for a total of 90 minutes to observe for any adverse drug reactions. During the 90-minute observation period, other medications will be allowed to be administered to the patient. All medications received during this time period will be documented in the patient data sheet. If an adverse drug reaction occurs, the attending physician or medical resident caring for the patient will be notified to come evaluate the patient. Adverse drug reaction severity will be determined by the attending physician or medical resident based on a predetermined scale. Adverse drug reaction information will be collected to determine correlation of adverse drug reaction to drug administration. Adverse drug reactions deemed as serious will be reported to the Institutional Review Board (IRB) within 5 days of the event.

Enrollment

220 estimated patients

Sex

All

Ages

18+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

  • Age 18 or older
  • Patients who present to the adult ED in whom IV aztreonam, cefazolin, cefoxitin, ceftriaxone, cefepime, ertapenem, or meropenem is ordered by the treating physician

Exclusion criteria

  • Pregnant or breastfeeding
  • Non-English speaking patient
  • Attending provider excludes patient
  • Unable to consent
  • Prisoner
  • Allergy to any beta-lactam antibiotic

Trial design

Primary purpose

Other

Allocation

Randomized

Interventional model

Parallel Assignment

Masking

Double Blind

220 participants in 2 patient groups

Syringe Arm
Experimental group
Description:
IV antibiotics will be delivered by syringe IV push over 2-3 minutes
Treatment:
Device: Syringe IV Push over 2-3 minutes
Piggyback Arm
Sham Comparator group
Description:
IV antibiotics will be delivered by IV piggyback over 30 minutes
Treatment:
Device: Piggyback over 30 minutes

Trial contacts and locations

1

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Central trial contact

Yili Gan, MS; Wesley J Forred, RN

Data sourced from clinicaltrials.gov

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