Grant: Operating Grant: Clinical Trials Projects

Antimicrobial Resistance (AMR) poses a major challenge for human health and is in large part fueled by overuse of antibiotics. Use of "last-resort" antibiotics has been increasing in Canadian hospitals, especially in intensive care units (ICU), where fear of under-treating critically ill patients can lead to excessive or inappropriate antibiotic use. New tools are needed to improve physicians' ability to distinguish between the types of infections that require antibiotics and those that do not, so they can make better prescription decisions with fewer inappropriate prescriptions, and therefore reduce the harm potentially related to antibiotic overuse or misuse. Our goal is to determine whether a novel diagnostic test called MeMed BV (referred to as BV) can improve physicians' clinical decisions and optimize antibiotic use in the ICU. The test has undergone testing in a large number of patients treated in outpatient clinics, emergency departments and wards, but it is not known whether this test can be helpful in the ICU setting. The study will be conducted at the McGill University Health Centre (MUHC), a network of hospitals providing advanced medical care for a population of 1.9 million, in a geographic area spanning 63% of the territory of Quebec. The study will involve a group of participants who will receive specific antibiotic treatment recommendations based on the BV test result in addition to usual care, and a control group who will receive usual care alone. We will study whether the participants who received specific treatment guidance based on the test result are less exposed to antibiotics and have fewer side effects without suffering additional complications (such as infection) compared to those who are given only routine care. If successful, the findings of this study will encourage hospitals across Canada and beyond to incorporate improved strategies for antibiotic treatment decisions, thereby reducing antibiotic overuse and the burden of AMR.