Integrated Clinical Decision Support for Empiric Antibiotic Selection in Sepsis
As antibiotic resistance increases globally, it becomes more difficult to select empiric antibiotic therapy, particularly in patients with sepsis who stand to benefit from early adequate treatment. In particular it is difficult for clinicians to balance antibiotic stewardship principles (the need to avoid unnecessary p
| Condition(s) | Sepsis, Bacterial Infections, Community-Acquired Infections, Hospital Infection |
|---|---|
| Status | Recruiting |
| Phase | NA |
| Study type | Interventional |
| Summary | As antibiotic resistance increases globally, it becomes more difficult to select empiric antibiotic therapy, particularly in patients with sepsis who stand to benefit from early adequate treatment. In particular it is difficult for clinicians to balance antibiotic stewardship principles (the need to avoid unnecessary prescribing of antibiotics that have an excessively broad spectrum of activity that favour resistance development) and under treatment. The integration of multiple risk variables for resistance are hard for clinicians to translate into clinical action, and is seemingly at odds with the natural inclination to provide heuristic/emotion-based antibiotic selection. The inappropriate treatment of sepsis is not uniformly too broad, or too narrow, and there is a need to optimize and |
| Who can participate | Inclusion Criteria: 1. Admitted 2. Age \>18 years old 3. Newly started (within 24 hours of assessment for eligibility) on at least one of the following antibiotic(s): I. Vancomycin IV II. Linezolid III. Daptomycin IV. Clindamycin V. Cefazolin VI. Cloxacillin VII. Ceftriaxone VIII. Ceftazidime IX. Piperacillin-Tazobactam X. Meropenem (or Imipenem or Ertapenem) XI. Ciprofloxacin 4. Blood cultures ordered (within 12 hours before or after initiation of index antibiotics). Overall Exclusion: 1. Pregnancy/breastfeeding 2. Documented end-of-life (palliative) care and are/will not be receiving ongoing antibiotic treatment. 3. Already enrolled in the trial. 4. Positive clinical culture results (those with speciation) for the index infection (within 72 hours) already available prior to assessment. B |
| Ages | 18 Years |
| Sex | All |
| Lead sponsor | Ottawa Hospital Research Institute |
| Locations | Mississauga, Ontario, Canada; Ottawa, Ontario, Canada; Toronto, Ontario, Canada |
| Start date | 2024-05-21 |
| NCT ID | NCT06103500 |
| Official listing | https://clinicaltrials.gov/study/NCT06103500 |