Swab Testing for Community-Acquired Pneumonia

(STOP-Vanc Trial)

Overseen By George Nelson, MD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Vanderbilt University Medical Center

Must be taking: Vancomycin

Disqualifiers: Hospital stay >48 hours, Prisoner

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: 1 week

277 Participants Needed

Trial Summary

What is the purpose of this trial?

This trial tests if quickly informing doctors that a patient does not have MRSA can reduce the use of a strong antibiotic called vancomycin in critically ill adults with pneumonia. The goal is to avoid unnecessary antibiotic use and its serious side effects.

Research Team

Jeffrey Freiberg, MD, PhD

Principal Investigator

Vanderbilt University Medical Center

Eligibility Criteria

Adults over 18 with suspected pneumonia, admitted to Vanderbilt University Medical Center's MICU from the ER or hospital floor within 48 hours. They must be in the MICU and on vancomycin without prior nasal decolonization. Prisoners or those hospitalized for over 48 hours before MICU admission are excluded.

Inclusion Criteria

I was admitted to the MICU and received a vancomycin order within 24 hours.

I am an adult admitted to the MICU from the ER or hospital floor within 48 hours.

I was suspected of having pneumonia when I was admitted.

Exclusion Criteria

Known to be a prisoner

I was in the hospital for more than 2 days before going to the MICU.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

1 week

Treatment

Participants receive either MRSA nasal swab testing with potential vancomycin de-escalation or no swab testing

1 week

Daily monitoring

Follow-up

Participants are monitored for safety and effectiveness after treatment, including 30-day all-cause mortality

30 days

Treatment Details

Interventions

• MRSA Nasal Swab PCR

Trial Overview The study tests if a rapid PCR swab alerting doctors of negative MRSA results can reduce vancomycin use in critically ill adults with community-acquired pneumonia, compared to standard care without such alerts.

Participant Groups

Group I: MRSA Nasal Swab Active Control 1 Intervention

Subjects will have a nasal swab collected and sent to the clinical laboratory for the MRSA nasal swab PCR test to be run. For the subjects assigned to the intervention group who have a negative MRSA nasal swab PCR result, providers will receive a pager alert which inform them of the negative result and will direct clinicians to clinical guidance recommending clinicians to discontinue vancomycin, if clinically appropriate.

Group II: No MRSA Nasal Swab Active Control 1 Intervention

Subjects will not have a nasal swab collected.

Who Is Running the Clinical Trial?

Vanderbilt University Medical Center

Lead Sponsor

Trials

922

Recruited

939,000+