[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"health-studies-list:{\"conditionNormalized\":\"antibiotic-stewardship\",\"overallStatus\":[\"RECRUITING\",\"AVAILABLE\",\"NOT_YET_RECRUITING\"],\"orderBy\":\"LastUpdateSubmitDate:desc\",\"size\":25,\"offset\":0}":3,"health-study-condition:antibiotic-stewardship":29},{"pageToken":4,"total":5,"offset":6,"count":5,"results":7},null,6,0,[8,52,85,110,139,164],{"id":9,"slug":10,"hasResults":11,"nctId":12,"briefTitle":13,"officialTitle":14,"acronym":15,"eligibilityCriteria":16,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":19,"targetDuration":4,"studyType":22,"phases":23,"briefSummary":25,"conditions":26,"keywords":32,"overallStatus":39,"whyStopped":4,"lastUpdateSubmitDate":40,"lastUpdatePostDateStruct":41,"startDateStruct":44,"completionDateStruct":46,"leadSponsor":48,"locationsCount":51},"100613517","early-antibiotics-adaptation-in-severe-pneumoniathe-early-adapt-study-100613517",false,"NCT07267624","EARLY Antibiotics aDAptation in Severe Pneumonia(The EARLY ADAPT Study)","EARLY Antibiotics aDaptation in Ventilator-Acquired-Pneumonia Treatment After Implementation of a Broad-Panel Respiratory Multiplex PCR Test: A Multicenter Randomized Control Trial Conducted In Swiss Intensive Care Units. The EARLY ADAPT Study.","EARLY ADAPT","Inclusion Criteria:\n\n* Adult patients (≥ 18 years old)\n* Hospitalized in intensive care with invasive mechanical ventilation ≥ 48 hours\n* Administration of antimicrobial therapy for suspected VAP at the time of inclusion.\n* Expected survival \\> 96 hours.\n\nExclusion Criteria:\n\n* Enrollment prior to the current trial\n* Participation in an interventional study on the management of AMR that has a direct impact on antibiotic therapy practices.","ALL","18 Years",{"count":20,"type":21},170,"ESTIMATED","INTERVENTIONAL",[24],"NA","The objective of the study is to determine whether rapid multiplex PCR testing of respiratory samples can reduce exposure to broad-spectrum antibiotics in intensive care unit patients with suspected or confirmed ventilator-associated pneumonia, compared to standard diagnostic methods.\n\nAs secondary objectives, the investigators will study antibiotic management and overall antibiotic consumption, as well as escalation or de-escalation events. The investigators will study the potential clinical impact of using multiplex PCR to see if the length of stay in the intensive care unit is reduced, as well as the duration of mechanical ventilation.",[27,28,29,30,31],"VAP - Ventilator Associated Pneumonia","Antibiotic","Antibiotic Stewardship","Antibiotic Prescribing for Acute Respiratory-tract Infections","Intensive Care (ICU)",[33,34,35,36,37,38],"ventilator Associated Pneumonia (VAP)","antibiotic","PCR multiplex","intensive care","broad spectrum antibiotic","stewardship","NOT_YET_RECRUITING","2026-04-28",{"date":42,"type":43},"2026-04-29","ACTUAL",{"date":45,"type":21},"2026-06-05",{"date":47,"type":21},"2028-06-30",{"name":49,"class":50},"University Hospital, Geneva","OTHER",5,{"id":53,"slug":54,"hasResults":11,"nctId":55,"briefTitle":56,"officialTitle":57,"acronym":58,"eligibilityCriteria":59,"healthyVolunteers":11,"sex":17,"minAge":60,"maxAge":61,"enrollmentInfo":62,"targetDuration":4,"studyType":22,"phases":64,"briefSummary":65,"conditions":66,"keywords":70,"overallStatus":75,"whyStopped":4,"lastUpdateSubmitDate":76,"lastUpdatePostDateStruct":77,"startDateStruct":79,"completionDateStruct":81,"leadSponsor":82,"locationsCount":84},"100586946","lung-ultrasound-for-guiding-antibiotic-use-in-pediatric-pneumonia-100586946","NCT06921993","Lung Ultrasound for Guiding Antibiotic Use in Pediatric Pneumonia","Lung Ultrasound for Antibiotic Stewardship in Community-Acquired Pneumonia: A Randomized Clinical Trial","LUSCAP","Inclusion Criteria:\n\n* Well-appearing, clinically stable patients aged 3 to 10 years, presenting to the pediatric ED with suspected pneumonia based on a combination of signs and symptoms suggestive of lower respiratory tract infection (LRTI), including:\n\n  1. Respiratory Symptoms: Cough, Tachypnea, Dyspnea (Increased work of breathing), Abnormal findings on auscultation.\n  2. Systemic Symptoms: Fever, Hypoxia, Decreased appetite.\n\n     Exclusion Criteria:\n* Neonates and children up to 3 years of age, and children older than 10 years\n* Children aged 3 to 10 years with any of the following factors:\n\n  1. Recent hospitalization (within the past 14 days)\n  2. Prior CXR or any other chest imaging (e.g. CT scan)\n  3. Ongoing antibiotic therapy\n  4. Hemodynamic instability\n  5. Respiratory failure or severe respiratory distress and\u002For hypoxemia, requiring urgent assessment for conditions such as pneumothorax, hemothorax, or other emergency respiratory conditions\n  6. History of aspiration or ab ingestis pneumonia\n  7. Underlying medical conditions predisposing to severe or recurrent pneumonia, including immunodeficiency, chronic corticosteroid use, chronic lung disease, malignancy, sickle cell disease, congenital heart disease, tracheostomy, and neuromuscular disorders affecting respiration","3 Years","10 Years",{"count":63,"type":21},659,[24],"Pneumonia is a major cause of illness and death in children, with an annual incidence of about 3.3 per 1,000 in those under five years old, many requiring hospitalization. The diagnosis is challenging due to the absence of a universally accepted gold standard, leading to variability in emergency settings. Current guidelines recommend diagnosis based on history and physical examination, which do not reliably differentiate pneumonia from other respiratory infections or identify whether it is bacterial or viral in nature. This uncertainty can lead to the unnecessary use of antibiotics.\n\nCommonly used chest X-rays have limitations such as low sensitivity, moderate interobserver reliability, and the inability to distinguish bacterial from viral pneumonia. In contrast, lung ultrasound has shown high sensitivity and specificity for diagnosing pneumonia in children. However, lung ultrasound also cannot reliably distinguish between bacterial and viral causes and might lead to increased antibiotic prescriptions by detecting minor lung consolidations not seen on chest X-rays. Despite these issues, lung ultrasound is widely used in pediatric pulmonary assessment.\n\nThe primary objective of the study is to determine if using lung ultrasound for diagnosing pneumonia in children can reduce antibiotic prescriptions compared to the standard care approach-which mainly relies on clinical diagnosis (often supplemented by chest X-ray and blood tests in selected cases). The secondary objective is to assess how frequently lung ultrasound impacts management decisions during a single clinical visit, beyond the information provided by history and physical examination. The third objective is to compare the diagnostic accuracy of lung ultrasound-supported diagnosis with existing diagnostic methods.\n\nThe study hypothesizes that lung ultrasound results can act as a decision modifier, similar to other clinical tools and examination findings. However, a lack of consensus on specific lung ultrasound parameters and their clinical correlations contributes to variability in managing suspected pneumonia, potentially leading to antibiotic overuse.\n\nEligible participants are children aged three to ten years who are in good general condition and clinically stable, presenting with signs and symptoms of lower respiratory tract infection indicative of pneumonia. Exclusion criteria include children outside the specified age range, those recently hospitalized, those who have undergone prior chest imaging, those already on antibiotic therapy, those with severe clinical instability, and those with underlying conditions predisposing them to severe or recurrent pneumonia. These criteria help ensure that the study population represents general pediatric community-acquired pneumonia cases, avoiding biases from high-risk patients.\n\nThe ultimate goal of this study is to provide evidence on whether lung ultrasound can serve as a reliable tool to guide antibiotic prescriptions, thereby reducing unnecessary antibiotic use in the management of pediatric pneumonia.",[67,68,69,29],"Pneumonia Childhood","Pneumonia","Lung Ultrasound",[68,71,72,73,74],"Children","Pediatrics","Lung ultrasound","point-of-care ultrasound","RECRUITING","2026-04-02",{"date":78,"type":43},"2026-04-03",{"date":80,"type":43},"2025-04-24",{"date":47,"type":21},{"name":83,"class":50},"Meyer Children's Hospital IRCCS",18,{"id":86,"slug":87,"hasResults":11,"nctId":88,"briefTitle":89,"officialTitle":90,"acronym":4,"eligibilityCriteria":91,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":92,"targetDuration":4,"studyType":22,"phases":94,"briefSummary":95,"conditions":96,"keywords":99,"overallStatus":75,"whyStopped":4,"lastUpdateSubmitDate":101,"lastUpdatePostDateStruct":102,"startDateStruct":104,"completionDateStruct":106,"leadSponsor":108,"locationsCount":93},"100575468","vancomycin-reduction-practices-vrp-in-the-nicu-100575468","NCT06772675","Vancomycin Reduction Practices (VRP) in the NICU","Implementing Vancomycin Reducing Practices (VRP) in Preterm Infants","Inclusion Criteria:\n\n* Level III NICU\n* Affiliated with Kaiser Permanente Northern California (KPNC) or Children's Hospital of Philadelphia Newborn Care Network (CNBCN)\n* Recruited by study team\n\nExclusion Criteria:\n\n* Site not recruited for the study",{"count":93,"type":21},13,[24],"This multi-center, cluster randomized study aimed at improving implementation of vancomycin reducing practices (VRP) in neonatal intensive care units (NICUs). Sites will be recruited and randomized to receive either external facilitation or no external facilitation to assess the effect on center-level fidelity to the core components of VRP implementation. Interventions available to both study arms are directed at hospital staff and includes identification of local champions, educational outreach, unit-level audit \\& feedback, and use of a clinical decision support tool.",[29,97,98],"Neonatal Sepsis, Late-Onset","Vancomycin",[100],"implementation study","2025-12-18",{"date":103,"type":43},"2025-12-24",{"date":105,"type":43},"2025-06-02",{"date":107,"type":21},"2027-09",{"name":109,"class":50},"Children's Hospital of Philadelphia",{"id":111,"slug":112,"hasResults":11,"nctId":113,"briefTitle":114,"officialTitle":115,"acronym":4,"eligibilityCriteria":116,"healthyVolunteers":11,"sex":17,"minAge":117,"maxAge":18,"enrollmentInfo":118,"targetDuration":4,"studyType":120,"phases":4,"briefSummary":121,"conditions":122,"keywords":124,"overallStatus":75,"whyStopped":4,"lastUpdateSubmitDate":129,"lastUpdatePostDateStruct":130,"startDateStruct":132,"completionDateStruct":134,"leadSponsor":136,"locationsCount":138},"100414801","antibiotic-prescription-in-children-hospitalized-for-community-acquired-pneumonia-100414801","NCT04681339","Antibiotic Prescription in Children Hospitalized for Community-acquired Pneumonia","Antibiotic Prescription in Children Hospitalized for Community-acquired Pneumonia: a Prospective, Observational Study","Inclusion Criteria:\n\n* Hospital admission at the pediatric department of the Filderklinik or at the pediatric department of the Herdecke Community Hospital\n* Admission diagnosis pneumonia or pneumonia diagnosis within 48 hours of admission\n* Written informed consent by care giver\n* All inclusion criteria have to be fulfilled\n\nExclusion Criteria:\n\n* Insufficient knowledge of German to understand the written patient information and questionnaire","3 Months",{"count":119,"type":21},200,"OBSERVATIONAL","A study to observe how often antibiotics are prescribed in children hospitalized for pneumonia and how doctors decide if a child needs antibiotics or not. Parent satisfaction will also be recorded.",[123,29],"Community Acquired Pneumonia in Children",[125,126,72,127,128],"Community acquired pneumonia","Antibiotic use","Hospitalised children","Integrative medicine","2025-01-07",{"date":131,"type":43},"2025-01-08",{"date":133,"type":43},"2022-09-16",{"date":135,"type":21},"2025-12",{"name":137,"class":50},"ARCIM Institute Academic Research in Complementary and Integrative Medicine",2,{"id":140,"slug":141,"hasResults":11,"nctId":142,"briefTitle":143,"officialTitle":144,"acronym":4,"eligibilityCriteria":145,"healthyVolunteers":146,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":147,"targetDuration":4,"studyType":22,"phases":148,"briefSummary":149,"conditions":150,"keywords":4,"overallStatus":75,"whyStopped":4,"lastUpdateSubmitDate":154,"lastUpdatePostDateStruct":155,"startDateStruct":157,"completionDateStruct":159,"leadSponsor":161,"locationsCount":163},"100420437","antibiotic-usage-prior-to-onabotulinumtoxina-injection-100420437","NCT04754737","Antibiotic Usage Prior to OnabotulinumtoxinA Injection","Optimizing Antibiotic Use in Treatment of Overactive Bladder: Evaluating the Need for Prophylactic Antibiotics Prior to OnabotulinumtoxinA Injection in Patients Without Urinary Tract Infection","Inclusion Criteria:\n\n* Age ≥ 18\n* Diagnosis of OAB who have failed 1st and 2nd line therapies per the AUA\u002FSUFU OAB guidelines (including bladder training, dietary modification and pharmacotherapy with an anticholinergic and\u002For beta-3 agonist)\n* Not symptomatic for UTI at the time of injection\n* Negative urinalysis at the time of the injection defined as: negative for nitrites and leukocyte esterace, with urine white blood cell count less than 5 per high-power field\n* Consent to participate in the study.\n\nExclusion Criteria:\n\n* Antibiotic usage within 48 hours prior to intradetrusor onabotulinumtoxinA injection\n* Women who are pregnant or planning to become pregnant, women who are breastfeeding\n* Concurrent use of onabotulinumtoxinA injection with maximum cumulative dose exceeding 400 units in a 3-month interval.",true,{"count":119,"type":21},[24],"Intradetrusor injection of onabotulinumtoxinA, which is performed through a cystoscopic procedure, has been demonstrated to be efficacious in the treatment of both neurogenic and non-neurogenic overactive bladder (OAB), and is FDA approved as a treatment for overactive bladder. Intradetrusor of onabotulinumtoxinA is currently standard of care of patients with OAB who have persistent OAB symptoms despite behavioral therapies and oral medication treatments for OAB. As one of the main adverse events associated with intradetrusor injection of onabotulinumtoxinA is UTI, and published guidelines for cystoscopic procedures with manipulation recommend the use of prophylactic antibiotics, a single dose of prophylactic antibiotic is administered prior to this procedure. However, these recommendations are primarily based on data from randomized controlled trials (RCTs) involving antimicrobial prophylaxis during transurethral resection of the prostate. A previously published prospective study demonstrated that the rate of post-procedural UTI did not differ amongst patients with neurogenic bladder who did not receive prophylactic antibiotics and were asymptomatic for UTI, regardless of whether they had sterile urine cultures or asymptomatic bacteriuria, suggesting that patients who are not symptomatic for UTI may not require antibiotic prophylaxis prior to intradetrusor onabotulinumtoxinA injection. Studies have reported that up to 50% of antibiotic usage is inappropriate, leading to unnecessary exposure of patients to potential complications of antibiotic therapy, including Clostridium difficile infection which can cause recurrent diarrhea that may progress to sepsis and death, increasing antibiotic resistances, as well as dermal\u002Fallergic and gastro-intestinal manifestations. Therefore, in an effort to optimize antibiotic use, the investigators propose a prospective, randomized study to formally evaluate the differences in UTI frequency in subjects who have a negative urinalysis and are not symptomatic for UTI and receive prophylactic antibiotics at the time of intradetrusor onabotulinumtoxinA injection compared to those who do not receive prophylactic antibiotics at the time of injection. The proposed study seeks to evaluate the current practice standard of antibiotic prophylaxis prior to intradetrusor onabotulinumtoxin injection.",[29,151,152,153],"Overactive Bladder","Onabotulinumtoxin A","UTI","2024-05-23",{"date":156,"type":43},"2024-05-24",{"date":158,"type":43},"2021-03-23",{"date":160,"type":21},"2026-12",{"name":162,"class":50},"Benaroya Research Institute",1,{"id":165,"slug":166,"hasResults":11,"nctId":167,"briefTitle":168,"officialTitle":169,"acronym":170,"eligibilityCriteria":171,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":172,"targetDuration":4,"studyType":22,"phases":174,"briefSummary":176,"conditions":177,"keywords":180,"overallStatus":39,"whyStopped":4,"lastUpdateSubmitDate":181,"lastUpdatePostDateStruct":182,"startDateStruct":184,"completionDateStruct":186,"leadSponsor":188,"locationsCount":4},"100537520","phase-3-early-neutropenic-fever-de-escalation-of-antibiotics-study-100537520","NCT06278896","Early Neutropenic Fever De-escalation of Antibiotics Study","Early Neutropenic Fever De-escalation (END) of Antibiotics Study","END","Inclusion Criteria:\n\n1. Participant or healthcare proxy with the ability to understand and willingness to sign an informed consent.\n2. Adults \\>18 years old.\n3. Likely to have neutropenia \\> 7 days including such conditions as: acute leukemia; lymphoproliferative disease; multiple myeloma; myelodysplastic syndrome; bone marrow aplasia and autologous or allogeneic hematopoietic stem cell transplantation. Neutropenia defined as absolute neutrophil count \\\u003C500.\n4. Received or planned to receive cytotoxic chemotherapy. No restrictions on prior therapy regarding dose or agent.\n5. High-risk neutropenia defined as expected duration of absolute neutrophil count less than 500 cells\u002FµL for seven or more days.\n6. Admitted as an inpatient at Mass General Brigham or Dana Farber Cancer Institute (DFCI).\n7. Initial fever (defined as a single oral temperature of ≥38.3°C or a temperature of ≥38.0°C sustained over a one-hour period) during hospital admission or as reason for admission.\n8. Has been afebrile for 48 hours.\n\nExclusion Criteria:\n\n1. Microbiologically or clinically suspected bacterial infection after index fever.\n2. Exposure to treatment antibacterial therapy 72 hours before first fever occurrence other than antibiotics deemed as prophylaxis.",{"count":173,"type":21},260,[175],"PHASE3","This is a randomized, open label clinical trial among individuals with hematologic conditions. The trial aims to evaluate the safety and clinical outcomes of de-escalating antibiotic therapy among stable individuals diagnosed with neutropenic fever, in which no bacterial infection has been identified.",[178,179,29],"Hematologic Malignancy","Febrile Neutropenia",[179],"2024-02-23",{"date":183,"type":43},"2024-02-26",{"date":185,"type":21},"2024-03-01",{"date":187,"type":21},"2028-03-01",{"name":189,"class":50},"Brigham and Women's Hospital"]