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| Name | Class |
|---|---|
| Mahidol University | OTHER |
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We will conduct a cluster randomized controlled trial to compare two antibiotic pre-authorization strategies (Fellow-based vs. Pharmacist-based). We believe that amount and duration of antibiotic consumption would be lower in the pharmacist group while the clinical outcome would be equivalent between two groups.
Study design: A cluster randomized controlled trial Settings: 6 general medical wards at Siriraj Hospital, Bangkok, Thailand
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Fellow arm | Active Comparator | Patients in this arm will receive the ID fellow-based antibiotic pre-authorization intervention. |
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| Pharmacist arm | Active Comparator | Patients in this arm will receive the pharmacist-based antibiotic pre-authorization intervention. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| ID fellow-based antibiotic pre-authorization | Procedure | All prescriptions of controlled antibiotics (Piperacillin/Tazobactam, Imipenem/Cilastatin, Meropenem and Doripenem) can be freely prescribed for the first 72 hours. After that, the prescription requires approval. Antibiotic preauthorization program will be operated by ID-fellows, under the supervision of ID staffs. |
| Measure | Description | Time Frame |
|---|---|---|
| Defined Daily Dose (DDD) of antibiotics | DDD of antibiotic use for that given infection (all antibiotics and controlled antibiotics) | Participants will be followed for the total duration of antibiotic therapy for that given infection, an expected average of 2 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Total duration of antibiotic use | Total duration of antibiotic use for that given infection (all antibiotics and controlled antibiotics) | Participants will be followed for the total duration of antibiotic therapy for that given infection, an expected average of 2 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Clinical response | Clinial response (cure, improved, not improved, dead and refer) at the end of therapy and at discharge | at the end of therapy and at discharge (an average duration of antibiotic therapy is 2 weeks, an average length of stay is 3 weeks) |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Pinyo Rattanaumpawan, MD, MSCE | Mahidol University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Siriraj Hospital | Bangkok | Bangkok | 10700 | Thailand |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 30156171 | Derived | Rattanaumpawan P, Upapan P, Thamlikitkul V. A noninferiority cluster-randomized controlled trial on antibiotic postprescription review and authorization by trained general pharmacists and infectious disease clinical fellows. Infect Control Hosp Epidemiol. 2018 Oct;39(10):1154-1162. doi: 10.1017/ice.2018.198. Epub 2018 Aug 29. |
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| Pharmacist-based antibiotic pre-authorization | Procedure | All prescriptions of controlled antibiotics (Piperacillin/Tazobactam, Imipenem/Cilastatin, Meropenem and Doripenem) can be freely prescribed for the first 72 hours. After that, the prescription requires approval. Antibiotic preauthorization program will be operated by general pharmacists, under the supervision of ID staffs. |
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