NCT03256825

Rapid Urinary Tract Infection Diagnosis and Real-time Antimicrobial Stewardship Decision Support

Rapid Urinary Tract Infection Diagnosis and Real-time Antimicrobial Stewardship Decision Support - Accuracy and Effect on Antibiotic Consumption

• Status: Completed
• Phase: N/A
• Study type: Interventional
• Enrollment: 400 (actual)
• Sponsor: Helse Møre og Romsdal HF · Other Government
• Sex: All
• Age: 18 Years
• Healthy volunteers: Not accepted

Summary

The study aims to assess the accuracy and impact of rapid diagnosis and rapid diagnosis decision support on different aspects of antibiotic consumption when implemented alone or together.

Detailed description

This interventional study in two centers compares two groups with each other and with a pre-intervention control group. In group 1 rapid techniques for handling urine cultures will be the only intervention. In group 2 rapid diagnostics will be supplemented with real-time antimicrobial stewardship decision support (RADS). In each center two departments will be involved. Urine samples present at the laboratory at opening on weekdays will be screened using urine flow cytometry and microscopy of centrifuged gram stained urine. Samples found positive for significant mono microbial bacteriuria will be investigated further by using direct automated phenotypic identification and antimicrobial susceptibility determination and screened for inclusion in the interventional study. In one of the centers, rapid techniques will be coupled to real-time antimicrobial stewardship decision support (RADS). RADS will be given by telephone to a designated clinician with the aim of: 1. Switch to active treatment if non-working empirical treatment 2. De-escalate broad spectrum empiric treatment when feasible 3. Promote early intravenous to per oral switch 4. Shorten treatment duration

Conditions

• Urinary Tract Infections

Interventions

Type	Name	Description
DIAGNOSTIC_TEST	Rapid diagnostics alone	Urine samples present at the laboratory at opening on weekdays will be screened using urine flow cytometry and microscopy of centrifuged gram stained urine. Samples found positive for significant mono microbial bacteriuria will be investigated further by using direct automated phenotypic identification and antimicrobial susceptibility determination.
OTHER	Real-time antimicrobial stewardship decision support	A clinical microbiologist will be give RADS by phone to a designated clinician with the aim of: 1. Switch to active treatment if non-working empirical treatment 2. De-escalate broad spectrum empiric treatment when feasible 3. Promote early intravenous to per oral switch 4. Shorten treatment duration

Timeline

• Start date: 2017-09-01
• Primary completion: 2019-11-01
• Completion: 2019-11-01
• First posted: 2017-08-22
• Last updated: 2020-05-12

Locations

2 sites across 1 country: Norway