INHALE

INHALE WP3 RCT health economic analysis now published in Critical Care.
The Pneumonia Panel PCR had lower average ICU costs and was cost effective for antimicrobial stewardship, but not clinical cure.

Read in full at: rdcu.be/eAmSD

YouTube video by INHALE Trial INHALE Poem II - A Slight Diversion

‘INHALE Poem II – A slight diversion’ shares the journey of the INHALE study, describing its hopes, challenges and the implications of the research.
This poem was written and performed by Amander Wellings, of the INHALE Patient, Carer and Public Involvement (PPI) group.

youtu.be/-UUBzbSmEo0?...

What is the impact of seeking pathogens by rapid molecular diagnostic methods on antibiotic stewardship and the clinical outcomes in hospital-acquired and ventilator-associated pneumonia (HAP and VAP)?

Visual abstract below and full paper available online at rdcu.be/ehlAu

Our call to to resistance, led by @angelahuttner.bsky.social and first published in @cmicomms.bsky.social, now published in @cmijournal.bsky.social too

www.clinicalmicrobiologyandinfection.com/article/S119...

INHALE compared rapid testing with standard care used to diagnose pneumonia in intensive care. Rapid testing gave faster results than standard care and improvements in antibiotic use. But, the machine did not improve cure of pneumonia, so more research is needed to understand why.

Guidelines vs mindlines: a qualitative investigation of how clinicians’ beliefs influence the application of rapid molecular diagnostics in intensive care | Antimicrobial Agents and Chemotherapy Rapid molecular diagnostic tests for pathogens and resistance genes may improve antibiotic-prescribing decisions and stewardship. However, clinicians’ desire to protect their patients with antibiotics...

4/4 "Guidelines vs mindlines: A qualitative investigation of how clinicians' beliefs influence the application of rapid molecular diagnostics in intensive care", published in Antimicrobial Agents and Chemotherapy is now available.
journals.asm.org/doi/10.1128/...

3/4 Implementation strategies for technological solutions to antimicrobial resistance must be ‘behaviourally intelligent’, recognising the challenges facing clinicians when making ‘life or death’ prescribing decisions.

2/4 limiting the application of these tests in practice.
Findings underscore the challenge of changing prescribing decisions based on technical results or guidelines, highlighting factors such as clinicians’ previous experience, and ‘knowledge in practice, to be more proximal drivers of decisions.

1/4 Rapid molecular diagnostic tests for pathogens and resistance genes may improve antibiotic prescribing decisions and stewardship. However, clinicians’ desire to protect their patient with an antibiotic often overrides more distal concerns about possible resistance selection,

Also sub-group analysis didn't suggest difference in outcomes between sample types but admittedly we didn't have many BALs.

No, we didn't formally assess here as had done & published before in same population. Informal analysis suggested results similar, and PCR found more organisms than culture. The method is semi-quant so you can have some clues to colonisation vs. infection - but no current method is 100% on this.

Guidelines vs mindlines: a qualitative investigation of how clinicians’ beliefs influence the application of rapid molecular diagnostics in intensive care | Antimicrobial Agents and Chemotherapy Rapid molecular diagnostic tests for pathogens and resistance genes may improve antibiotic-prescribing decisions and stewardship. However, clinicians’ desire to protect their patients with antibiotics...

🚨 New Paper from Dr SJ Stewart and the INHALE team @inhale-trial.bsky.social

“Guidelines vs Mindlines” published in Antimicrobial Agents and Chemotherapy

journals.asm.org/doi/10.1128/...

2/2 More research on clinical impact is urgently needed. A holistic approach, including behavioural intervention to optimise antibiotic prescribing, is likely needed to fully realise the potential benefits of rapid diagnostics and their role in mitigating AMR.

INHALE WP3, a multicentre, open-label, pragmatic randomised controlled trial assessing the impact of rapid, ICU-based, syndromic PCR, versus standard-of-care on antibiotic stewardship and clinical out... Purpose INHALE investigated the impact of seeking pathogens by PCR on antibiotic stewardship and clinical outcomes in hospital-acquired and ventilator-associated pneumonia (HAP and VAP). Methods This ...

1/2 The INHALE WP3 randomised trial provides multi-centre evidence that rapid syndromic PCR, delivered at the point-of care in the ICU improved antibiotic stewardship by 21% in absolute terms. Equivalence of clinical cure was not demonstrated link.springer.com/article/10.1...