Improving the Treatment of Acute Uncomplicated Diverticulitis in Routine Care (AUD)
From Guidelines to Real-world Practice: a Pragmatic Before and After Study on the Treatment of Acute Uncomplicated Diverticulitis (AUD) Based on a Risk Factor Driven Treatment Algorithm (AUD Management Algorithm Protocol)
Acute uncomplicated diverticulitis is often treated with antibiotics, although current evidence shows that antibiotics are not always necessary. This study will evaluate whether a more standardized approach to treatment can reduce unnecessary antibiotic use without increasing the risk of treatment failure.
The study will compare patients treated before and after the new treatment approach is introduced in participating Swiss hospitals. Information on treatment, hospital admissions, complications and recurrence of diverticulitis will be collected. Patients will be followed for up to 24 months.
調査の概要
研究の種類
入学 (推定)
段階
- 適用できない
連絡先と場所
研究連絡先
- 名前:Dimitri Christoforidis, MD
- メール:Dimitrios.Christoforidis@eoc.ch
研究連絡先のバックアップ
- 名前:Elena Porro, Msc
- 電話番号:0041918117038
- メール:ricerca.chirurgiaorl@eoc.ch
参加基準
適格基準
就学可能な年齢
- 大人
- 高齢者
健康ボランティアの受け入れ
説明
Inclusion Criteria:
- Age 18 years or older
- CT-confirmirmed acute uncomplicated diverticulitis of the left colon
- Ability to provide informed consent for participants in the prospective phase
Exclusion Criteria:
- Complicated acute diverticulitis, defined as diverticulitis with abscess, perforation (free air), fistula, or distant free fluid
Diverticulitis of the right or transverse colon
-.Alternative diagnosis explaining the participant's symptoms
- No possibility of completing the 90-day follow-up
- Inability to provide informed consent for the prospective phase
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:非ランダム化
- 介入モデル:並列代入
- マスキング:なし(オープンラベル)
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
|
他の:Antibiotic Treatment
Participants with acute uncomplicated diverticulitis who receive antibiotic treatment according to the standardized treatment approach.
|
A standardized treatment approach based on clinical findings, laboratory results, comorbidities, immunosuppression status, and CT findings is introduced to support treatment decisions in patients with acute uncomplicated diverticulitis.
Depending on these factors, patients may be managed with or without antibiotics.
|
|
他の:No Antibiotic Treatment Arm Description:
Participants with acute uncomplicated diverticulitis who are managed without antibiotics according to the standardized treatment approach.
|
A standardized treatment approach based on clinical findings, laboratory results, comorbidities, immunosuppression status, and CT findings is introduced to support treatment decisions in patients with acute uncomplicated diverticulitis.
Depending on these factors, patients may be managed with or without antibiotics.
|
この研究は何を測定していますか?
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Treatment failure
時間枠:Within 90 days after diagnosis
|
Treatment failure is defined as a composite outcome including progression to complicated diverticulitis requiring percutaneous abscess drainage or surgery, delayed initiation of antibiotics after initial management without antibiotics, or unplanned hospital admission following initial outpatient treatment.
|
Within 90 days after diagnosis
|
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Antibiotic use
時間枠:Within 90 days after diagnosis
|
Proportion of participants receiving antibiotics
|
Within 90 days after diagnosis
|
|
Adherence to the standardized treatment approach
時間枠:At the initial treatment decision
|
Proportion of participants whose management is consistent with the standardized treatment approach.
|
At the initial treatment decision
|
|
Outpatient versus inpatient management
時間枠:At the initial treatment decision
|
roportion of participants initially managed as outpatients versus inpatients.
|
At the initial treatment decision
|
|
Hospital admission
時間枠:Within 30 days after diagnosis
|
Proportion of participants readmitted to hospital.
|
Within 30 days after diagnosis
|
|
Recurrence of diverticulitis
時間枠:Within 24 months after diagnosis
|
Proportion of participants experiencing recurrence of diverticulitis.
|
Within 24 months after diagnosis
|
協力者と研究者
捜査官
- 主任研究者:Dimitri Christoforidis, MD、EOC
研究記録日
主要日程の研究
研究開始 (推定)
一次修了 (推定)
研究の完了 (推定)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。