基于远程医疗的儿科抗生素管理计划：一项阶梯式楔形集群随机试验的研究方案 - TeleKasper 研究。

Telemedicine-based antibiotic stewardship program in pediatrics: study protocol of a stepped wedge cluster randomized trial-the TeleKasper study.

机构信息

Institute for Medical Epidemiology, Biometrics and Informatics (IMEBI), Medical Faculty, Interdisciplinary Centre for Health Sciences, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.

Section of Clinical Infectious Diseases, University Hospital Halle (Saale), Halle (Saale), Germany.

出版信息

Trials. 2024 Oct 14;25(1):678. doi: 10.1186/s13063-024-08493-z.

DOI:10.1186/s13063-024-08493-z

PMID:39402608

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11476715/

Abstract

BACKGROUND

Overuse and misuse of antibiotics is one of the driving factors of antimicrobial resistance, a growing global health threat. The use of antibiotics is particularly high in children. Even though the implementation of antibiotic stewardship programs (ASP) in pediatrics has been shown to reduce antibiotic use, this implementation has been limited to large university hospitals in Germany. Telemedicine applications might be an effective approach to implement ASP in non-university settings.

METHODS

This protocol details the TeleKasper study (Telemedical Competence Network "Antibiotic Stewardship in Pediatrics"). Tele-Kasper is a stepped-wedge cluster-randomized trial that will be conducted across non-university children's hospitals in Germany. The intervention consists of a telemedical consultation service in the form of a network in different German areas, using an app as a communication tool. The primary outcome will be a 20% reduction in overall antibiotic consumption measured using defined daily doses per 100 patient days.

DISCUSSION

The TeleKasper study aims to implement and evaluate a prototype for a nationwide antibiotic stewardship program by telemedical means in pediatric departments in non-university hospitals in Germany to promote rational antibiotic use and improve medical care for infections.

TRIAL REGISTRATION

German Clinical Trials Register (DRKS) DRKS00028534. Registered on 22nd of April 2022.

摘要

背景

抗生素的过度使用和滥用是抗菌药物耐药性的驱动因素之一，这是一个日益严重的全球健康威胁。儿童是抗生素使用量特别高的人群。尽管在儿科实施抗生素管理计划（ASP）已被证明可以减少抗生素的使用，但这种实施仅限于德国的大型大学医院。远程医疗应用程序可能是在非大学环境中实施 ASP 的有效方法。

方法

本方案详细介绍了 TeleKasper 研究（远程医疗能力网络“儿科抗生素管理”）。Tele-Kasper 是一项在德国非大学儿童医院进行的阶梯式楔形集群随机试验。干预措施包括以不同德国地区网络形式提供的远程医疗咨询服务，并使用应用程序作为沟通工具。主要结果将是使用每 100 个患者天的定义日剂量衡量的总体抗生素消耗减少 20%。