[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"health-studies-list:{\"conditionNormalized\":\"bronchiolitis-viral\",\"overallStatus\":[\"RECRUITING\",\"AVAILABLE\",\"NOT_YET_RECRUITING\"],\"orderBy\":\"LastUpdateSubmitDate:desc\",\"size\":25,\"offset\":0}":3,"health-study-condition:bronchiolitis-viral":31},{"pageToken":4,"total":5,"offset":6,"count":5,"results":7},null,2,0,[8,45],{"id":9,"slug":10,"hasResults":11,"nctId":12,"briefTitle":13,"officialTitle":14,"acronym":15,"eligibilityCriteria":16,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":19,"enrollmentInfo":20,"targetDuration":4,"studyType":23,"phases":24,"briefSummary":26,"conditions":27,"keywords":4,"overallStatus":32,"whyStopped":4,"lastUpdateSubmitDate":33,"lastUpdatePostDateStruct":34,"startDateStruct":37,"completionDateStruct":39,"leadSponsor":41,"locationsCount":44},"100576653","reducing-overuse-of-antibiotics-with-decision-support-100576653",false,"NCT06788093","Reducing Overuse of Antibiotics With Decision Support","Reducing Overuse of Antibiotics With Decision Support in Lower Respiratory Tract Infections","ROADS","Inclusion Criteria:\n\n1. ED encounter or admission to an inpatient hospital team.\n2. EHR-based positive screen for suspected LRTI, defined as a qualifying chief complaint (e.g., cough, shortness of breath, etc.), plus triage documentation of abnormal respiratory effort and\u002For cough.\n\nExclusion Criteria: None","ALL","6 Months","17 Years",{"count":21,"type":22},2800,"ESTIMATED","INTERVENTIONAL",[25],"NA","Eliminating inappropriate antibiotic use in pediatric lower respiratory tract infections (LRTI) is the central focus of this research. LRTIs (pneumonia, bronchiolitis, and infection-related exacerbations of asthma) account for nearly one-third of all emergency department (ED) visits and 40% of all infection-related hospitalizations in US children. LRTIs also account for more antibiotic use in children's hospitals than any other condition, despite most LRTIs being viral in nature. Inappropriate antibiotics are associated with substantial adverse effects. Accordingly, national guidelines strongly discourage routine antibiotic use for bronchiolitis and acute asthma and argue for significantly reducing antibiotic exposure (initiation, spectrum, and duration) in pneumonia.\n\nTo address the problem of inappropriate antibiotic use, hospital-based antimicrobial stewardship programs (ASPs) are now common nationwide, and these programs have demonstrated effectiveness in some hospital settings. Unfortunately, traditional ASP approaches do not translate well to the fast-paced and unpredictable ED environment, and hospital-based ASP resources are finite and not always immediately available.\n\nClinical decision support (CDS) embedded within the electronic health record (EHR) is a strategy that could address the ED antibiotic stewardship gap. Informed by a deep understanding of the key facilitators and barriers to using CDS to support appropriate antibiotic use in ED and hospital settings, the investigators have developed two stewardship-focused CDS interventions for pediatric LRTI. The overarching goal of this research is to rigorously evaluate the implementation and effectiveness of these CDS tools, alone and in combination, against usual care only in a pragmatic randomized clinical trial at 3 U.S. children's hospitals.",[28,29,30,31],"Lower Respiratory Tract Infection","Pneumonia","Asthma","Bronchiolitis, Viral","RECRUITING","2026-01-19",{"date":35,"type":36},"2026-01-22","ACTUAL",{"date":38,"type":36},"2024-11-12",{"date":40,"type":22},"2027-04",{"name":42,"class":43},"Vanderbilt University Medical Center","OTHER",3,{"id":46,"slug":47,"hasResults":11,"nctId":48,"briefTitle":49,"officialTitle":50,"acronym":4,"eligibilityCriteria":51,"healthyVolunteers":11,"sex":17,"minAge":52,"maxAge":53,"enrollmentInfo":54,"targetDuration":4,"studyType":56,"phases":4,"briefSummary":57,"conditions":58,"keywords":4,"overallStatus":62,"whyStopped":4,"lastUpdateSubmitDate":63,"lastUpdatePostDateStruct":64,"startDateStruct":66,"completionDateStruct":68,"leadSponsor":70,"locationsCount":4},"100614415","effectiveness-of-immunization-in-preventing-severe-acute-respiratory-infection-rsv-100614415","NCT07279298","Effectiveness of Immunization in Preventing Severe Acute Respiratory Infection RSV","Effectiveness of Immunization in Preventing Severe Acute Respiratory Infection Associated With Respiratory Syncytial Virus-RSV- in Infants Under 6 Months of Age in Bogotá: a Case-control Study With a Negative Test Design","Inclusion Criteria:\n\n* Age: Infants younger than 6 months at the time of hospital admission.\n* Residence: Maternal residence in Bogotá, Colombia, verified through clinical record, identification document, or health system registry.\n* Clinical Condition: Hospitalization due to severe acute respiratory infection (SARI) meeting the district operational definition (presence of fever, cough, and\u002For signs of respiratory distress, requiring inpatient management).\n* Laboratory Testing: Respiratory specimen collected and tested for RSV by RT-PCR or validated antigen test within ≤48 hours of hospital admission, or repeated within 24-48 hours if initial test is negative.\n* Exposure Eligibility Window: Infant born ≥5 weeks after the start of the RSVpreF maternal vaccination campaign in Bogotá, ensuring opportunity for maternal immunization.\n\nExclusion Criteria:\n\n* Prematurity: Infants born at ≤32 weeks of gestation.\n* Healthcare-associated respiratory infection: Symptom onset \\>48 hours after hospital admission for another condition.\n* Non-respiratory hospital admission: Primary reason for hospitalization unrelated to respiratory disease (e.g., trauma, elective surgery).\n* Vaccination status unverifiable: Inability to confirm maternal RSVpreF vaccination status after reasonable attempts to verify through registry, vaccination card, or prenatal documentation.\n* Duplicate episodes: Readmission for the same respiratory episode ≤14 days after discharge (only the first episode will be included).\n* Delayed sampling: First respiratory sample obtained \\>48-72 hours after initial admission to the health system.\n* Lethal congenital conditions: Congenital or genetic disorders incompatible with life or that substantially alter the expected clinical course.\n* Concurrent interventional study participation: Enrollment in another clinical trial that may affect respiratory outcomes.\n* Inability to establish mother-infant linkage due to adoption, loss of parental custody, or absence of biological maternal records.","1 Day","180 Days",{"count":55,"type":22},1097,"OBSERVATIONAL","This study aims to evaluate the real-world effectiveness of two preventive immunization strategies against Respiratory Syncytial Virus (RSV)-associated severe acute respiratory infection in infants less than six months of age in Bogotá, Colombia. The strategies include maternal vaccination with RSVpreF administered between 28 and 36 weeks of gestation and neonatal immunization with nirsevimab for infants born to mothers who did not receive RSVpreF during pregnancy. Using a test-negative case-control design embedded in the city's sentinel surveillance system, infants hospitalized for severe respiratory infection will be systematically tested for RSV. Comparative vaccine effectiveness will be estimated to determine the impact of maternal RSV vaccination and neonatal monoclonal antibody immunization on RSV-associated hospitalizations, intensive care admissions, and mortality. The study will generate real-world evidence to inform local and regional public health decisions and guide the implementation of cost-effective hybrid immunization strategies against RSV in middle-income settings.",[59,60,31,61],"Respiratory Syncytial Virus Infections","Severe Acute Respiratory Infection","Viral Respiratory Tract Infection","NOT_YET_RECRUITING","2025-12-01",{"date":65,"type":36},"2025-12-12",{"date":67,"type":22},"2026-02-01",{"date":69,"type":22},"2027-07-31",{"name":71,"class":72},"Bogotá District Health Secretariat","OTHER_GOV"]