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| ID | Type | Description | Link |
|---|---|---|---|
| 80-82310-97-12044 | Other Grant/Funding Number | ZonMw |
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| Name | Class |
|---|---|
| ZonMw: The Netherlands Organisation for Health Research and Development | OTHER |
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The purpose of this study is to compare the cost(effectiveness) of three existing antibiotic strategies for patients with community-acquired pneumonia admitted to the hospital, but not the ICU.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Betalactam monotherapy | Active Comparator | Preferred empirical treatment for patients in this arm is Beta-lactam monotherapy e.g. co-amoxiclav or ceftriaxone |
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| Betalactam combination with macrolide | Active Comparator | Preferred empirical treatment for patients in this arm is beta-lactam combination therapy with a macrolide e.g. ceftriaxone and erythromycin |
|
| Quinolone monotherapy | Active Comparator | Preferred empirical treatment for patients in this arm is quinolone monotherapy e.g. moxifloxacin or levofloxacin |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Preferred empirical treatment | Other | The investigators are using a cluster-randomized cross-over design for preferred empirical treatment. One of the 3 treatment arms is used as preferred empirical therapy during a period of 4 consecutive months, after which preferred treatment will rotate to 1 of the other 2 regimens. The order of change is randomised per hospital, thereby controlling for inter-hospital variables and minimizing seasonal influences. |
| Measure | Description | Time Frame |
|---|---|---|
| Day 90 Mortality | We will assess all-cause mortality on day 90 from admission from the municipal personal records database | 90 days from admission |
| Measure | Description | Time Frame |
|---|---|---|
| Length of intravenous antibiotic treatment | Participants will be followed for the duration of hospital stay, an expected average of 1 week | |
| Length of hospital stay | Participants will be followed for the duration of hospital stay, an expected average of 1 week |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Marc J. Bonten, MD PhD | UMC Utrecht | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Medical Center Alkmaar | Alkmaar | Netherlands | ||||
| AMC Amsterdam |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 30612559 | Derived | Postma DF, Spitoni C, van Werkhoven CH, van Elden LJR, Oosterheert JJ, Bonten MJM. Cardiac events after macrolides or fluoroquinolones in patients hospitalized for community-acquired pneumonia: post-hoc analysis of a cluster-randomized trial. BMC Infect Dis. 2019 Jan 7;19(1):17. doi: 10.1186/s12879-018-3630-7. | |
| 28068956 | Derived |
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| Tolerability | Side-effects and complications from antibiotic therapy are registered from clinical record | Participants will be followed for the duration of hospital stay, an expected average of 1 week |
| Complications | Complications of pneumonia during admission are registered from clinical record. | Participants will be followed for the duration of hospital stay, an expected average of 1 week |
| Health care costs and non-health care costs | Health care costs and non-health care costs are assessed using a short questionnaire 28 days from admission | 28 days from admission |
| Amsterdam |
| Netherlands |
| Amphia Hospital Breda | Breda | Netherlands |
| Kennemer Gasthuis | Haarlem | Netherlands |
| Spaarne Hospital | Hoofddorp | Netherlands |
| Diakonessenhuis Utrecht | Utrecht | Netherlands |
| UMC Utrecht | Utrecht | Netherlands |
| van Werkhoven CH, Postma DF, Mangen MJ, Oosterheert JJ, Bonten MJ; CAP-START study group. Cost-effectiveness of antibiotic treatment strategies for community-acquired pneumonia: results from a cluster randomized cross-over trial. BMC Infect Dis. 2017 Jan 10;17(1):52. doi: 10.1186/s12879-016-2179-6. |
| 25830421 | Derived | Postma DF, van Werkhoven CH, van Elden LJ, Thijsen SF, Hoepelman AI, Kluytmans JA, Boersma WG, Compaijen CJ, van der Wall E, Prins JM, Oosterheert JJ, Bonten MJ; CAP-START Study Group. Antibiotic treatment strategies for community-acquired pneumonia in adults. N Engl J Med. 2015 Apr 2;372(14):1312-23. doi: 10.1056/NEJMoa1406330. |
| 24846935 | Derived | van Werkhoven CH, Postma DF, Oosterheert JJ, Bonten MJ. Antibiotic treatment of moderate-severe community-acquired pneumonia: design and rationale of a multicentre cluster-randomised cross-over trial. Neth J Med. 2014 Apr;72(3):170-8. |
| ID | Term |
|---|---|
| D000098968 | Community-Acquired Pneumonia |
| D011014 | Pneumonia |
| ID | Term |
|---|---|
| D017714 | Community-Acquired Infections |
| D007239 | Infections |
| D012141 | Respiratory Tract Infections |
| D012140 | Respiratory Tract Diseases |
| D008171 | Lung Diseases |
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