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Discharge Antibiotic Stewardship for Pediatric Infections (DISCO Trial)

N/A

Waitlist Available

Led By Jeffrey S Gerber, MD, PhD

Research Sponsored by Children's Hospital of Philadelphia

Eligibility Criteria Checklist

Specific guidelines that determine who can or cannot participate in a clinical trial

Must have

Be younger than 65 years old

Must not have

Patient: Subjects >18 years of age, hospital length of stay >7 days, requiring intensive care unit level of care

Clinician: <18 years old, not employed by the hospital

Timeline

Screening 3 weeks

Treatment Varies

Follow Up up to 3 years

Awards & highlights

No Placebo-Only Group

Summary

This trial tests if a discharge stewardship bundle can reduce inappropriate antibiotic prescribing for kids with 3 common infections. It will involve surveys, interviews and feedback reports.

Who is the study for?

This trial is for children under 18 with common infections like pneumonia, UTIs, or skin infections who are being discharged from the hospital. It's also for their parents and healthcare providers over 18 working at the hospital. Children who stayed in the hospital longer than a week or needed intensive care are not eligible.

What is being tested?

The study tests a 'discharge stewardship bundle' to see if it helps reduce unnecessary antibiotic prescriptions when kids leave the hospital after treatment for pneumonia, UTI, or skin infections. The intervention will be adapted and implemented across four children's hospitals.

What are the potential side effects?

Since this trial focuses on improving antibiotic prescribing practices rather than testing new medications, side effects are not a primary concern of this study. However, antibiotics can typically cause digestive issues or allergic reactions.

Eligibility Criteria

Exclusion Criteria

You may be eligible for the trial if you check “No” for criteria below:

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I am over 18, have been in the hospital for more than 7 days, and need intensive care.

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I am under 18 and do not work for the hospital.

Timeline

Screening ~ 3 weeks3 visits

Treatment ~ Varies

Follow Up ~ up to 3 years

Screening ~ 3 weeks

Treatment ~ Varies

Follow Up ~up to 3 years

This trial's timeline: 3 weeks for screening, Varies for treatment, and up to 3 years for reporting.

Treatment Details

Study Objectives

Study objectives can provide a clearer picture of what you can expect from a treatment.

Primary study objectives

Rate of suboptimal prescribing

Secondary study objectives

Impact of the discharge stewardship intervention on adverse drug events

Impact of the discharge stewardship intervention on post-discharge treatment failure

Awards & Highlights

No Placebo-Only Group

All patients enrolled in this study will receive some form of active treatment.

Trial Design

2Treatment groups

Experimental Treatment

Active Control

Group I: Pediatric HospitalistsExperimental Treatment1 Intervention

Prescribing physicians and hospital employees will be recruited during regularly held staff meetings prior to the data collection period. The study team will briefly introduce the study aims and methods and let the hospitalists know that the study team will be emailing them separately to ask permission for Dr. Szymczak to shadow them. Only those who have agreed will participate in the ethnographic observations. For the interviews and surveys, the study team will recruit respondents via contact made during ethnographic observations. The study team will also utilize a snowball approach by asking respondents if they know of any other staff who might be interested in participating in an interview. Approximately 120 clinicians will participate in the interviews and surveys.

Group II: Families of hospitalized childrenActive Control1 Intervention

Families of children who were hospitalized at one of the four participating sites will be approached for consent to participate in the study. Families who consent will complete 2 brief REDCap surveys and a wellness tracker after their child is discharged from the hospital.

0 / 2Eligibility criteria met