Itapetininga

Healthcare-associated infections (HAIs) are a major issue in intensive care units (ICUs), often caused by contamination with multidrug-resistant organisms that remain despite routine cleaning. This trial evaluates different surface disinfection methods to reduce such contamination and improve patient outcomes. It is a cluster-randomized, crossover study conducted in 12 Brazilian ICUs, comparing usual cleaning methods with additional disinfection technologies. The trial involves three sequential strategies in each ICU: usual surface disinfection alone; usual disinfection followed by aerosolized hydrogen peroxide sprayed at 7.9% concentration inside a protective tent during terminal cleaning of patient beds; and usual disinfection followed by automated ultraviolet-C light irradiation applied under the same protective tent to disinfect beds and nearby surfaces. These methods are compared to assess their impact on infection control. Participants admitted to the ICUs will be monitored for antimicrobial use, which is the primary outcome measured as daily defined doses per 100 patient-days over three months. Secondary outcomes include rates of HAIs, environmental contamination by resistant organisms, specific infection types like ventilator-associated pneumonia, bloodstream infections, urinary tract infections, and ICU length of stay and costs. The study includes assessments of contamination and infection rates during each intervention period to evaluate effectiveness and safety.

Researchers are evaluating whether patients with ventilator-associated tracheobronchitis (VAT) in intensive care units benefit from a 7-day course of antibiotics compared to clinical observation without antibiotic treatment. This trial is a national, multicenter, single-blinded, randomized non-inferiority study aiming to determine if monitoring without antibiotics is as effective as antibiotic therapy for VAT, given the current uncertainty and conflicting guidelines about antibiotic use for this condition. Participants diagnosed with VAT will be randomly assigned to one of two groups. One group will receive standard care plus a 7-day antibiotic course, while the other group will have clinical observation without antibiotics unless they develop new organ dysfunction or infections other than VAT. The study focuses on comparing these two approaches to see if withholding antibiotics is noninferior in managing VAT. During the study, patients will be monitored for ventilator-free days within 28 days after randomization. Researchers will assess clinical status, chest imaging, and tracheal secretion cultures. Safety and treatment effects will be carefully tracked, with data analysis conducted in a blinded manner. The trial encompasses ICU patients who have been mechanically ventilated for at least 48 hours and meet specific clinical and laboratory criteria for VAT.