The main objective of this study is to investigate whether checklist-based close telephone consultation and process surveillance for S. aureus bacteraemia (SAB) can improve adherence to our in-house SAB-guidelines (prospective quality- improvement group). In addition, the effects of telephone consultation on the clinical outcome of patients will be examined.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
OTHER
Masking
NONE
Enrollment
124
The treating doctor will be called on day 1 and 12 after SAB diagnosis to point out the standard of care (as per our evidence-based in-hospital standard operating procedure (SOP)) for SAB. On day 2 and 6 after SAB diagnosis, there will be additional phone calls if clinical management does not follow hospital guidelines. The study team will also leave comments in the medical charts of the respective patients if the management does not follow hospital guidelines.
Greifswald University Medicine
Greifswald, Germany
SOP adherence, calculated as a sum score per patient with the following 8 parameters:
1. Drawing of follow-up blood cultures 2-3 days after start of adequate antibiotic therapy 2. Early source control (removal of infected material or drainage of an abscess ≤ 72 hrs) 3. Adequate search for SAB focus and metastatic manifestations 4. TEE in patients with clinical indications (within 4 days of SAB diagnosis) 5. Early start of specific therapy after receipt of results via phone call (≤12 hrs) 6. Adequate dosage of antibiotic 7. Sufficient duration of therapy (at least 14 d for uncomplicated bacteremia and 28 d for complicated bacteremia) 8. Combination therapy with Rifampicin or Fosfomycin, when indicated
Time frame: Hospital admission until hospital discharge (no later than day 90 after diagnosis)
Time to specific antimicrobial treatment according to guidelines concerning agent and duration
Time frame: Hospital admission until hospital discharge (no later than day 90 after diagnosis)
Time to negativity of follow up blood cultures
Time frame: Day of SAB diagnosis until hospital discharge (no later than day 90 after diagnosis)
Time till TEE is performed (when indicated)
Time frame: Hospital admission until hospital discharge (no later than day 90 after diagnosis)
Length of hospital stay after SAB diagnosis
Time frame: Day of SAB diagnosis until hospital discharge (no later than day 90 after diagnosis)
In-hospital mortality (all patients)
Time frame: Hospital admission until hospital discharge (no later than day 90 after diagnosis)
In-hospital mortality (because of SAB complications)
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Time frame: Hospital admission until hospital discharge (no later than day 90 after diagnosis)
Hospital readmission until day 30 after SAB diagnosis (all patients)
Time frame: Day of SAB diagnosis until day 30 after diagnosis
Hospital readmission until day 30 after SAB diagnosis (because of SAB complications)
Time frame: Day of SAB diagnosis until day 30 after diagnosis
Hospital readmission until day 90 after SAB diagnosis (all patients)
Time frame: Day of SAB diagnosis until day 90 after diagnosis
Hospital readmission until day 90 after SAB diagnosis (because of SAB complications)
Time frame: Day of SAB diagnosis until day 90 after diagnosis
90-day all-cause mortality
Time frame: Day of SAB diagnosis until day 90 after diagnosis
90-day mortality because of SAB complications
Time frame: Day of SAB diagnosis until day 90 after diagnosis
Relapse of bacteremia until day 90 after diagnosis
Time frame: Day of SAB diagnosis until day 90 after diagnosis
Quality of discharge summary (documentation and treatment plan), calculated as a sum score
Time frame: Hospital admission until hospital discharge (no later than day 90 after diagnosis)
Infectious diseases consultation, when indicated (yes/no)
Time frame: Hospital admission until hospital discharge (no later than day 90 after diagnosis)