INSPIRE Stewardship Bundle for Abdominal Infections
What You Need to Know Before You Apply
What is the purpose of this trial?
This trial aims to improve antibiotic use in hospitals for non-critically ill adults with abdominal infections. It compares the usual method of selecting antibiotics with a new system, the INSPIRE CPOE Smart Prompt for Abdominal Infection, which provides real-time advice through smart prompts. This guidance helps doctors choose the best antibiotics based on the likelihood of antibiotic resistance. The trial focuses on adults admitted to HCA Healthcare hospitals who have been prescribed extended-spectrum antibiotics for abdominal infections. Participants are from hospitals using a specific electronic health record system called MEDITECH. As an unphased trial, this study allows participants to contribute to innovative research that could enhance antibiotic use and patient care in hospitals.
Do I need to stop my current medications for the trial?
The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.
What prior data suggests that the INSPIRE CPOE Smart Prompt and Stewardship Bundle are safe for use in hospitals?
Research has shown that computerized tools, like the smart prompts in the INSPIRE Stewardship Bundle, can help doctors choose better antibiotics for abdominal infections. These smart prompts are digital aids, not medications or physical treatments, that assist doctors in selecting the most effective antibiotics.
Studies comparing these smart prompts to usual practices focused more on effectiveness than safety, as the prompts themselves don't directly affect health. No reports of negative effects from using these prompts have emerged. Instead, these tools help in selecting the right antibiotics, indirectly enhancing patient safety by reducing the risk of antibiotic resistance.
While specific safety data for the smart prompts themselves is lacking, they are considered a safe addition to current methods for treating abdominal infections.12345Why are researchers excited about this trial?
Researchers are excited about the INSPIRE Stewardship Bundle for abdominal infections because it introduces a smart, tech-driven approach to guide antibiotic use. Unlike standard antibiotic stewardship methods, which typically rely on clinician judgment and existing protocols, this bundle uses computerized physician order entry (CPOE) smart prompts to support decision-making right from the start of hospitalization. This method aims to enhance the accuracy and speed of empiric antibiotic choices, potentially improving patient outcomes and reducing antibiotic resistance. The integration of clinician feedback and educational activities further supports the adoption of these smart prompts, making it a comprehensive strategy to tackle abdominal infections effectively.
What evidence suggests that the INSPIRE Stewardship Bundle and CPOE Smart Prompt could be effective for abdominal infections?
In this trial, participants will be assigned to one of two treatment arms. Research has shown that the INSPIRE Stewardship Bundle for Abdominal Infection, one of the treatment arms, uses smart prompts through a computer system to improve antibiotic use. In earlier studies, hospitals using this system made better antibiotic choices for abdominal infections. These smart prompts assist doctors in selecting the right antibiotics by providing real-time advice. This method has led to reduced use of broad-spectrum antibiotics, helping to prevent antibiotic resistance. Overall, the INSPIRE system has proven effective in aiding doctors to make better antibiotic choices, thereby improving treatment for patients with abdominal infections.12346
Who Is on the Research Team?
Shruti Gohil, MD, MPH
Principal Investigator
UC Irvine Division of Infectious Diseases
Susan Huang, MD, MPH
Principal Investigator
UC Irvine Division of Infectious Diseases
Richard Platt, MD, MS
Principal Investigator
Harvard Pilgrim Health Care Institute/Harvard Medical School
Are You a Good Fit for This Trial?
This trial is for HCA Healthcare hospitals that admit adults with abdominal infections and use MEDITECH electronic health record systems. It's not about individual patients, but the hospitals themselves are the 'subjects' being studied.Inclusion Criteria
Exclusion Criteria
Timeline for a Trial Participant
Screening
Participants are screened for eligibility to participate in the trial
Treatment
Routine empiric antibiotic stewardship practices compared with CPOE smart prompts for the first 3 days of hospitalization
Extended Treatment
Monitoring and treatment with extended-spectrum antibiotics from hospital days 4 to 14
Follow-up
Participants are monitored for safety and effectiveness after treatment
What Are the Treatments Tested in This Trial?
Interventions
- INSPIRE CPOE Smart Prompt for Abdominal Infection
- INSPIRE Stewardship Bundle for Abdominal Infection
- Routine Care
Trial Overview
The INSPIRE Trial compares usual antibiotic treatments in hospitals to a new method using computer prompts that help doctors guess if an infection is resistant to antibiotics. Hospitals are grouped and randomly assigned to one of these two approaches.
How Is the Trial Designed?
2
Treatment groups
Active Control
Continuation of routine antibiotic stewardship strategies.
Use of computerized physician order entry (CPOE) smart prompts, clinician feedback, and activities to support CPOE adoption (including education and alignment of CPOE workflows) to guide empiric choice of antibiotics for abdominal infection in the first 3 days of hospitalization.
Find a Clinic Near You
Who Is Running the Clinical Trial?
Harvard Pilgrim Health Care
Lead Sponsor
Rush University
Collaborator
Hospital Corporation of America
Industry Sponsor
HCA Healthcare, Inc
Collaborator
University of California, Irvine
Collaborator
University of Massachusetts, Amherst
Collaborator
Brigham and Women's Hospital
Collaborator
Published Research Related to This Trial
Citations
NCT05423743 | INSPIRE Trial for Abdominal Infections
The INSPIRE Abdominal Infection Trial is a cluster-randomized controlled trial of HCA Healthcare hospitals comparing routine empiric antibiotic stewardship ...
The INSPIRE 4 Cluster Randomized Clinical Trial - PubMed
This 92-hospital cluster randomized clinical trial assessed the effect of an antibiotic stewardship bundle with CPOE prompts vs routine stewardship on ...
3.
rethinkingclinicaltrials.org
rethinkingclinicaltrials.org/news/grand-rounds-may-31-2024-inspire-abdominal-skin-soft-tissue-infection-trials-intelligent-stewardship-prompts-to-improve-real-time-empiric-antibiotic-selection-for-patients-shruti-k-gohil-md-m/INSPIRE Abdominal & Skin/Soft Tissue Infection Trials ...
The INSPIRE trials demonstrated the effectiveness of real-time, individualized smart prompts. In both the abdominal infection trial and the ...
Improving Empiric Antibiotic Selection for Patients ...
... (INSPIRE) for Abdominal Infection Routine. Stewardship vs Computerized Provider Order Entry (CPOE) Bundle on Trial Effectiveness and Safety Outcomes. 4. 2. 1.
5.
cidrap.umn.edu
cidrap.umn.edu/antimicrobial-stewardship/computerized-stewardship-alert-tied-improved-antibiotic-prescribing-skinComputerized stewardship alert tied to improved antibiotic ...
In two INSPIRE trials published in April 2024, the same team reported similar reductions in extended-spectrum antibiotic prescribing for ...
444. SHEA FEATURED ORAL ABSTRACT: INSPIRE Trial: A ...
This 92-hospital cluster-randomized trial compared CPOE prompts providing patient-specific absolute risk estimates for MDRO abdominal infection ...
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