Status:

RECRUITING

Ventilator-associated Tracheobronchitis Initiative to Conduct Antibiotic Evaluation

Lead Sponsor:

Hospital Sirio-Libanes

Collaborating Sponsors:

Hospital Israelita Albert Einstein

Hospital do Coracao

Conditions:

Ventilator Associated Tracheobronchitis

Tracheobronchitis

Eligibility:

All Genders

18+ years

Phase:

NA

Brief Summary

The Ventilator Associated tracheobronchitis Initiative to Conduct Antibiotic evaluation (VATICAN) trial is a national, multicenter, non-inferiority trial in ICU patients comparing antibiotic treatment...

Detailed Description

There is no consensus on the need for antibiotic treatment for ventilator-associated tracheobronchitis (VAT). There's a lack of high-quality clinical data on this subject, and although some observatio...

Eligibility Criteria

Inclusion

  • Admission to one of the participating ICUs
  • Invasive Mechanical ventilation ≥ 48 hours
  • Available chest imaging of screening day
  • Clinical diagnosis of VAT, defined by the presence of:
  • Temperature \>38.0°C or \<36°C OR leukocytes \>12000/mL or \<4000/mL or presence \>10% of immature forms, AND
  • Onset of purulent tracheal secretion, or change in characteristics of the secretion, or increase in the amount of respiratory secretion, or increased need for aspiration
  • Culture of tracheal secretion from the day of screening under analysis or collected for analysis

Exclusion

  • Pregnant or lactating women
  • Indication of use of antibiotics or use of systemic antibiotics for any indications at the time of screening
  • Hemodynamic instability, defined as hypotension unresponsive to volume expansion or increase in vasopressor dose \> 0.1mcg/kg/min of noradrenaline or equivalent in the past 6 hours
  • Worsening of gas exchange, defined as an increase in the fraction of inspired oxygen ≥ 20% or an increase in positive end-expiratory pressure (PEEP) ≥ 3 cm of water after a stability period ≥ 2 days
  • Prolonged mechanical ventilation, defined by use of invasive mechanical ventilation for 21 days or more
  • Presence of pulmonary radiological image suggestive of new infectious infiltrate
  • Previous lung disease that makes radiological interpretation for the diagnosis of VAP difficult
  • Previous diagnosis of ventilator associates pneumonia (VAP) during hospitalization
  • Neutropenic patients (neutrophils \<1000/mL)
  • Known severe immunosuppression
  • Tracheostomized patients at the time of screening
  • Inclusion in the study in the past 30 days
  • Expected limitation of care or early withdrawal of supportive therapies (\< 7 days)
  • Patients with a survival expectancy of less than 48 hours
  • Refusal of consent to participate in the study

Key Trial Info

Start Date :

July 11 2022

Trial Type :

INTERVENTIONAL

Allocation :

ESTIMATED

End Date :

December 1 2026

Estimated Enrollment :

590 Patients enrolled

Trial Details

Trial ID

NCT05266066

Start Date

July 11 2022

End Date

December 1 2026

Last Update

June 19 2025

Active Locations (16)

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Page 1 of 4 (16 locations)

1

Hospital OTOClinica

Fortaleza, Ceará, Brazil

2

Hospital Vila Velha

Vila Velha, Espírito Santo, Brazil

3

Hospital Santa Casa de Belo Horizonte

Belo Horizonte, Minas Gerais, Brazil

4

Hospital Vila da Serra

Nova Lima, Minas Gerais, Brazil