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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
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1 to 3 of 3 Research Studies DisplayedDeshpande A, Walker R, Schulte R
Reducing antimicrobial overuse through targeted therapy for patients with community-acquired pneumonia: a study protocol for a cluster-randomized factorial controlled trial (CARE-CAP).
The authors described a planned cluster-randomized controlled trial in 12 hospitals in the Cleveland Clinic Health System to test two approaches to reducing the use of extended-spectrum antibiotics (ESA) in adult patients with community-acquired pneumonia (CAP): rapid diagnostic assays that provide accurate results within hours, and de-escalation after negative bacterial cultures in clinically stable patients. The purpose will be to establish whether the identification of an etiological agent early and pharmacist-led de-escalation can safely reduce the use of ESA in patients with CAP. The findings may also inform clinical guidelines on the management of CAP.
AHRQ-funded; HS028633.
Citation: Deshpande A, Walker R, Schulte R .
Reducing antimicrobial overuse through targeted therapy for patients with community-acquired pneumonia: a study protocol for a cluster-randomized factorial controlled trial (CARE-CAP).
Trials 2023 Sep 16; 24(1):595. doi: 10.1186/s13063-023-07615-3..
Keywords: Antibiotics, Antimicrobial Stewardship, Medication, Community-Acquired Infections, Pneumonia, Respiratory Conditions
Deshpande A, Klompas M, Guo N
Intravenous to oral antibiotic switch therapy among patients hospitalized with community-acquired pneumonia.
The purpose of this retrospective cohort study was to examine clinical practice guidelines which recommend switching from intravenous (IV) to oral antibiotics once patients are clinically stable. The researchers conducted a study of adults admitted with CAP from 2010 through 2015 and initially treated with IV antibiotics at 642 US hospitals. Switching was defined as discontinuation of IV and initiation of oral antibiotics without interrupting therapy. Patients switched by hospital day 3 were considered early switchers. The study found that of 78,041 CAP patients, 6% were switched early, most frequently to fluoroquinolones. Patients switched early had fewer days on IV antibiotics, shorter duration of inpatient antibiotic treatment, shorter LOS, and lower hospitalization costs, but no significant excesses in 14-day in-hospital mortality or late ICU admission. Patients at a greater mortality risk were less likely to be switched. However, even in hospitals with relatively high switch rates, less than 15% of very low-risk patients were switched early.
AHRQ-funded; HS029477; HS025026.
Citation: Deshpande A, Klompas M, Guo N .
Intravenous to oral antibiotic switch therapy among patients hospitalized with community-acquired pneumonia.
Clin Infect Dis 2023 Jul 26; 77(2):174-85. doi: 10.1093/cid/ciad196..
Keywords: Antibiotics, Community-Acquired Infections, Pneumonia, Respiratory Conditions, Medication
Vaughn VM, Gandhi TN, Hofer TP
A statewide collaborative quality initiative to improve antibiotic duration and outcomes in patients hospitalized with uncomplicated community-acquired pneumonia.
Researchers sought to improve antibiotic duration for community-acquired pneumonia (CAP) across 41 hospitals participating in the Michigan Hospital Medicine Safety Consortium (HMS). They found that, across diverse hospitals, HMS participation was associated with more appropriate use of short-course therapy and fewer adverse events in hospitalized patients with uncomplicated CAP.
AHRQ-funded; HS026530.
Citation: Vaughn VM, Gandhi TN, Hofer TP .
A statewide collaborative quality initiative to improve antibiotic duration and outcomes in patients hospitalized with uncomplicated community-acquired pneumonia.
Clin Infect Dis 2022 Aug 31;75(3):460-67. doi: 10.1093/cid/ciab950..
Keywords: Community-Acquired Infections, Pneumonia, Antibiotics, Antimicrobial Stewardship, Medication, Respiratory Conditions