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1. External validation of the PAGE-B score for HCC risk prediction in people living with HIV/HBV coinfection

Author

Abela, I., Aebi-Popp, K., Anagnostopoulos, A., Battegay, M., Bernasconi, E., Braun, D.L., Bucher, H.C., Calmy, A., Cavassini, M., Ciuffi, A., Dollenmaier, G., Egger, M., Elzi, L., Fehr, J., Fellay, J., Furrer, H., Fux, C.A., Günthard, H.F., Hachfeld, A., Haerry, D., Hasse, B., Hirsch, H.H., Hoffmann, M., Hösli, I., Huber, M., Jackson-Perry, D., Kahlert, C.R., Kaiser, L., Keiser, O., Klimkait, T., Kouyos, R.D., Kovari, H., Kusejko, K., Labhardt, N., Leuzinger, K., de Tejada B, Martinez, Marzolini, C., Metzner, K.J., Müller, N., Nemeth, J., Nicca, D., Notter, J., Paioni, P., Pantaleo, G., Perreau, M., Rauch, A., Salazar-Vizcaya, L., Schmid, P., Speck, R., Stöckle, M., Tarr, P., Trkola, A., Wandeler, G., Weisser, M., Yerly, S., van der Valk, M., Geerlings, S.E., Goorhuis, A., Harris, V.C., Hovius, J.W., Lempkes, B., Nellen, F.J.B., van der Poll, T., Prins, J.M., Spoorenberg, V., van Vugt, M., Wiersinga, W.J., Wit, F.W.M.N., Bruins, C., van Eden, J., Hylkema-van den Bout, I.J., van Hes, A.M.H., Pijnappel, F.J.J., Smalhout, S.Y., Weijsenfeld, A.M., Back, N.K.T., Berkhout, B., Cornelissen, M.T.E., van Houdt, R., Jonges, M., Jurriaans, S., Schinkel, C.J., Wolthers, K.C., Zaaijer, H.L., Peters, E.J.G., van Agtmael, M.A., Autar, R.S., Bomers, M., Sigaloff, K.C.E., Heitmuller, M., Laan, L.M., van den Berge, M., Stegeman, A., Baas, S., Hage de Looff, L., van Arkel, A., Stohr, J., Wintermans, B., Pronk, M.J.H., Ammerlaan, H.S.M., de Munnik, E.S., Deiman, B., Jansz, A.R., Scharnhorst, V., Tjhie, J., Wegdam, M.C.A., van Eeden, A., Hoornenborg, E., Nellen, J., Alers, W., Elsenburg, L.J.M., Nobel, H., van Kasteren, M.E.E., Berrevoets, M.A.H., Brouwer, A.E., de Kruijf-van de Wiel, B.A.F.M., Adams, A., Rijkevoorsel, M. Pawels-van, Buiting, A.G.M., Murck, J.L., Rokx, C., Anas, A.A., Bax, H.I., van Gorp, E.C.M., de Mendonça Melo, M., van Nood, E., Nouwen, J.L., Rijnders, B.J.A., Schurink, C.A.M., Slobbe, L., de Vries-Sluijs, T.E.M.S., Bassant, N., van Beek, J.E.A., Vriesde, M., van Zonneveld, L.M., de Groot, J., van Kampen, J.J.A., Koopmans, M.P.G., Rahamat-Langendoen, J.C., Branger, J., Douma, R.A., Cents-Bosma, A.S., Duijf-van de Ven, C.J.H.M., Schippers, E.F., van Nieuwkoop, C., Geilings, J., van Winden, S., van der Hut, G., van Burgel, N.D., Leyten, E.M.S., Gelinck, L.B.S., Mollema, F., Wildenbeest, G.S., Nguyen, T., Groeneveld, P.H.P., Bouwhuis, J.W., Lammers, A.J.J., van Hulzen, A.G.W., Kraan, S., Kruiper, M.S.M., van der Bliek, G.L., Bor, P.C.J., Debast, S.B., Wagenvoort, G.H.J., Roukens, A.H.E., de Boer, M.G.J., Jolink, H., Lambregts, M.M.C., Scheper, H., Dorama, W., van Holten, N., Claas, E.C.J., Wessels, E., Hollander, J.G. den, El Moussaoui, R., Pogany, K., Brouwer, C.J., Heida-Peters, D., Mulder, E., Smit, J.V., Struik-Kalkman, D., van Niekerk, T., Pontesilli, O., van Tienen, C., Lowe, S.H., Lashof, A.M.L. Oude, Posthouwer, D., van Wolfswinkel, M.E., Ackens, R.P., Burgers, K., Elasri, M., Schippers, J., Havenith, T.R.A., van Loo, M., van Vonderen, M.G.A., Kampschreur, L.M., van Broekhuizen, M.C., S, Faber, Al Moujahid, A., Kootstra, G.J., Delsing, C.E., van der Burg-van de Plas, M., Scheiberlich, L., Kortmann, W., van Twillert, G., Renckens, R., Wagenaar, J., Ruiter-Pronk, D., van Truijen-Oud, F.A., Stuart, J.W.T. Cohen, Hoogewerf, M., Rozemeijer, W., Sinnige, J.C., Brinkman, K., van den Berk, G.E.L., Lettinga, K.D., de Regt, M., Schouten, W.E.M., Stalenhoef, J.E., Veenstra, J., Vrouenraets, S.M.E., Blaauw, H., Geerders, G.F., Kleene, M.J., Knapen, M., Kok, M., van der Meché, I.B., Toonen, A.J.M., Wijnands, S., Wttewaal, E., Kwa, D., van de Laar, T.J.W., van Crevel, R., van Aerde, K., Dofferhoff, A.S.M., Henriet, S.S.V., Hofstede, H.J.M. ter, Hoogerwerf, J., Richel, O., Albers, M., Grintjes-Huisman, K.J.T., de Haan, M., Marneef, M., McCall, M., Burger, D., Gisolf, E.H., Claassen, M., Hassing, R.J., Beest, G. ter, van Bentum, P.H.M., Gelling, M., Neijland, Y., Swanink, C.M.A., Velderman, M. Klein, van Lelyveld, S.F.L., Soetekouw, R., van der Prijt, L.M.M., van der Swaluw, J., Kalpoe, J.S., Wagemakers, A., Vahidnia, A., Lauw, F.N., Verhagen, D.W.M., van Wijk, M., Bierman, W.F.W., Bakker, M., van Bentum, R.A., van den Boomgaard, M.A., Kleinnijenhuis, J., Kloeze, E., Middel, A., Postma, D.F., Schenk, H.M., Stienstra, Y., Wouthuyzen-Bakker, M., Boonstra, A., de Jonge, H., Maerman, M.M.M., de Weerd, D.A., van Eije, K.J., Knoester, M., van Leer-Buter, C.C., Niesters, H.G.M., T.Mudrikova, Barth, R.E., Bruns, A.H.W., Ellerbroek, P.M., Hensgens, M.P.M., Oosterheert, J.J., Schadd, E.M., Verbon, A., van Welzen, B.J., Berends, H., Santen, B.M.G. Griffioen-van, de Kroon, I., Lunel, F.M. Verduyn, Wensing, A.M.J., Zaheri, S., Boyd, A.C., Bezemer, D.O., van Sighem, A.I., Smit, C., Hillebregt, M.M.J., Woudstra, T.J., Rutkens, T., Bergsma, D., Brétin, N.M., Lelivelt, K.J., van de Sande, L., van der Vliet, K.M. Visser.S.T., Paling, F., de Groot-Berndsen, L.G.M., van den Akker, M., Alexander, R., Bakker, Y., El Berkaoui, A., Bezemer-Goedhart, M., Djoechro, E.A., Groters, M., Koster, L.E., Lodewijk, C.R.E., Lucas, E.G.A., Munjishvili, L., Peeck, B.M., Ree, C.M.J., Regtop, R., van Rijk, A.F., Ruijs-Tiggelman, Y.M.C., Schnörr, P.P., Schoorl, M.J.C., Tuijn, E.M., Veenenberg, D.P., Witte, E.C.M., Karpov, I., Losso, M., Lundgren, J., Rockstroh, J., Aho, I., Rasmussen, L.D., Novak, P., Pradier, C., Chkhartishvili, N., Matulionyte, R., Oprea, C., Kowalska, J.D., Begovac, J., Miró, J.M., Guaraldi, G., Paredes, R., Peters, L., Larsen, J.F., Neesgaard, B., Jaschinski, N., Fursa, O., Raben, D., Kristensen, D., Fischer, A.H., Jensen, S.K., Elsing, T.W., Gardizi, M., Mocroft, A., Phillips, A., Reekie, J., Cozzi-Lepri, A., Pelchen-Matthews, A., Roen, A., Tusch, E.S., Bannister, W., Bellecave, P., Blanco, P., Bonnet, F., Bouchet, S., Breilh, D., Cazanave, C., Desjardin, S., Gaborieau, V., Gimbert, A., Hessamfar, M., Lacaze-Buzy, L., Lacoste, D., Lafon, M.E., Lazaro, E., Leleux, O., Le Marec, F., Le Moal, G., Malvy, D., Marchand, L., Mercié, P., Neau, D., Pellegrin, I., Perrier, A., Petrov-Sanchez, V., Vareil, M.O., Wittkop, L., Bernard, N., Chaussade, D. Bronnimann H., Dondia, D., Duffau, P., Faure, I., Morlat, P., Mériglier, E., Paccalin, F., Riebero, E., Rivoisy, C., Vandenhende, M.A., Barthod, L., Dauchy, F.A., Desclaux, A., Ducours, M., Dutronc, H., Duvignaud, A., Leitao, J., Lescure, M., Nguyen, D., Pistone, T., Puges, M., Wirth, G., Courtault, C., Camou, F., Greib, C., Pellegrin, J.L., Rivière, E., Viallard, J.F., Imbert, Y., Thierry-Mieg, M., Rispal, P., Caubet, O., Ferrand, H., Tchamgoué, S., Farbos, S., Wille, H., Andre, K., Caunegre, L., Gerard, Y., Osorio-Perez, F., Chossat, I., Iles, G., Labasse-Depis, M., Lacassin, F., Barret, A., Castan, B., Koffi, J., Rouanes, N., Saunier, A., Zabbe, J.B., Dumondin, G., Beraud, G., Catroux, M., Garcia, M., Giraud, V., Martellosio, J.P., Roblot, F., Pasdeloup, T., Riché, A., Grosset, M., Males, S., Bell, C. Ngo, Carpentier, C., Bellecave, Virology P., Tumiotto, C., Miremeont-Salamé, G., Arma, D., Arnou, G., Blaizeau, M.J., Camps, P., Decoin, M., Delveaux, S., Diarra, F., Gabrea, L., Lawson-Ayayi, S., Lenaud, E., Plainchamps, D., Pougetoux, A., Uwamaliya, B., Zara, K., Conte, V., Gapillout, M., Surial, Bernard, Ramírez Mena, Adrià, Roumet, Marie, Limacher, Andreas, Smit, Colette, Leleux, Olivier, Mocroft, Amanda, van der Valk, Marc, Bonnet, Fabrice, Peters, Lars, Rockstroh, Jürgen K., Günthard, Huldrych F., Berzigotti, Annalisa, Rauch, Andri, and Wandeler, Gilles

Published
2023
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2. Real-world effectiveness and tolerability of switching to doravirine-based antiretroviral therapy in people with HIV: a nationwide, matched, prospective cohort study

Author

Oomen, Patrick G A, Wit, Ferdinand W N M, Brinkman, Kees, Vrouenraets, Saskia M E, Mudrikova, Tania, van Welzen, Berend J, van der Valk, Marc, van Agtmael, M.A., Bomers, M., Geerlings, S.E., Goorhuis, A., Harris, V.C., Hovius, J.W., Lemkes, B., Nellen, F.J.B., Peters, E.J.G., van der Poll, T., Prins, J.M., Sigaloff, K.C.E., Spoorenberg, V., van Vugt, M., Wiersinga, W.J., Bruins, C., van Eden, J., Hylkema-van den Bout, I.J., Laan, L.M., Pijnappel, F.J.J., Smalhout, S.Y., Spelbrink, M.E., Weijsenfeld, A.M., Back, N.K.T., Cornelissen, M.T.E., van Houdt, R., Jonges, M., Jurriaans, S., Schinkel, C.J., Welkers, M.R.A., Wolthers, K.C., van den Berge, M., Stegeman, A., Baas, S., Hage de Looff, L., van Arkel, A., Stohr, J., Wintermans, B., Pronk, M.J.H., Ammerlaan, H.S.M., de Bree, C., de Munnik, E.S., Phaf, S., Deiman, B., Jansz, A.R., Scharnhorst, V., Tjhie, J., Wegdam, M.C.A., Nellen, J., van Eeden, A., Hoornenborg, E., de Stoppelaar, S., Alers, W., Elsenburg, L.J.M., Nobel, H., Schinkel, C.J., van Kasteren, M.E.E., Berrevoets, M.A.H., Brouwer, A.E., de Kruijf-van de Wiel, B.A.F.M., Adams, A., Pawels-van Rijkevoorsel, M., Murck, J.L., Rokx, C., Anas, A.A., Bax, H.I., van Gorp, E.C.M., de Mendonça Melo, M., van Nood, E., Nouwen, J.L., Rijnders, B.J.A., Schurink, C.A.M., Slobbe, L., de Vries-Sluijs, T.E.M.S., Bassant, N., van Beek, J.E.A., Vriesde, M., van Zonneveld, L.M., de Groot, J., van Kampen, J.J.A., Koopmans, M.P.G., Rahamat-Langendoen, J.C., Branger, J., Douma, R.A., Cents-Bosma, A.S., Mulder, M.A., Schippers, E.F., van Nieuwkoop, C., Geilings, J., van de Ven, E., van der Hut, G., van Burgel, N.D., Leyten, E.M.S., Gelinck, L.B.S., Mollema, F., Langbein, M., Wildenbeest, G.S., Nguyen, T., Groeneveld, P.H.P., Bouwhuis, J.W., Lammers, A.J.J., van Hulzen, A.G.W., Kraan, S., Kruiper, M.S.M., Debast, S.B., Wagenvoort, G.H.J., Roukens, A.H.E., de Boer, M.G.J., Jolink, H., Lambregts, M.M.C., Scheper, H., van Holten, N., van der Sluis, D., Claas, E.C.J., Wessels, E., den Hollander, J.G., El Moussaoui, R., Pogany, K., Brouwer, C.J., Heida-Peters, D., Mulder, E., Smit, J.V., Struik-Kalkman, D., van Niekerk, T., Pontesilli, O., van Tienen, C., Lowe, S.H., Oude Lashof, A.M.L., Posthouwer, D., Stoop, A., van Wolfswinkel, M.E., Ackens, R.P., Elasri, M., Houben-Pintaric, K., Schippers, J., Havenith, T.R.A., van Loo, M., van Vonderen, M.G.A., Kampschreur, L.M., Timmer, C., van Broekhuizen, M.C., Faber, S., Al Moujahid, A., Kootstra, G.J., Delsing, C.E., van der Burg-van de Plas, M., Scheiberlich, L., Kortmann, W., van Twillert, G., Renckens, R., Wagenaar, J., Ruiter-Pronk, D., Stander, B., Cohen Stuart, J.W.T., Hoogewerf, M., Rozemeijer, W., Sinnige, J.C., Brinkman, K., van den Berk, G.E.L., Lettinga, K.D., de Regt, M., Schouten, W.E.M., Stalenhoef, J.E., Blaauw, H., Geerders, G.F., Kleene, M.J., Knapen, M., Kok, M., van der Meché, I.B., Toonen, A.J.M., Wijnands, S., Wttewaal, E., Kwa, D., van de Laar, T.J.W., van Crevel, R., van Aerde, K., Dofferhoff, A.S.M., Henriet, S.S.V., ter Hofstede, H.J.M., Hoogerwerf, J., Richel, O., Albers, M., Grintjes-Huisman, K.J.T., de Haan, M., Marneef, M., McCall, M., Rahamat-Langendoen, J., Ruizendaal, E., Burger, D., Gisolf, E.H., Claassen, M., Hassing, R.J., ter Beest, G., van Bentum, P.H.M., Neijland, Y., Valette, M., Swanink, C.M.A., Klein Velderman, M., van Lelyveld, S.F.L., Soetekouw, R., van der Prijt, L.M.M., van der Swaluw, J., Kalpoe, J.S., Wagemakers, A., Vahidnia, A., Lauw, F.N., Verhagen, D.W.M., van Wijk, M., Bierman, W.F.W., Bakker, M., van Bentum, R.A., van den Boomgaard, M.A., Kleinnijenhuis, J., Kloeze, E., Middel, A., Postma, D.F., Schenk, H.M., Stienstra, Y., Wouthuyzen-Bakker, M., Boonstra, A., Maerman, M.M.M., de Weerd, D.A., van Eije, K.J., Knoester, M., van Leer-Buter, C.C., Niesters, H.G.M., Barth, R.E., Bruns, A.H.W., Ellerbroek, P.M., Hensgens, M.P.M., Oosterheert, J.J., Schadd, E.M., Verbon, A., Griffioen-van Santen, B.M.G., de Kroon, I., Schuurman, R., Verduyn Lunel, F.M., Wensing, A.M.J., van der Valk, M., Zaheri, S., Boyd, A.C., Bezemer, D.O., Jongen, V.W., van Sighem, A.I., Smit, C., Wit, F.W.M.N., Hillebregt, M.M.J., Woudstra, T.J., Rutkens, T., Bergsma, D., Brétin, N.M., Koster, L.E., Lelivelt, K.J., van de Sande, L., Schoorl, M.J.C., Visser, K.M., van der Vliet, S.T., Paling, F., van den Akker, M., Akpomukai, O.M., Alexander, R., Bakker, Y.M., Bastos Sales, L., El Berkaoui, A., Bezemer-Goedhart, M., Djoechro, E.A., Grolleman, J.M., El Hammoud, I., Khouw, M.R., Lodewijk, C.R.E., Lucas, E.G.A., van Meerveld-Derks, S., Mulder, H.W., Munjishvili, L., Ree, C.M.J., Regtop, R., van Rijk, A.F., Ruijs-Tiggelman, Y.M.C., Schnörr, P.P., van Veen, R., van Vliet-Klein Gunnewiek, W.H.G., and Witte, E.C.M.

Abstract

Currently, real-world data on doravirine are scarce. In a national prospective cohort, we assessed the effectiveness and tolerability of switching to doravirine-based antiretroviral therapy (ART) in people with HIV.

Published
2024
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3. Robust Vaccine-Induced as Well as Hybrid B- and T-Cell Immunity across SARS-CoV-2 Vaccine Platforms in People with HIV

Author

Verburgh, Myrthe L., primary, van Pul, Lisa, additional, Grobben, Marloes, additional, Boyd, Anders, additional, Wit, Ferdinand W. N. M., additional, van Nuenen, Ad C., additional, van Dort, Karel A., additional, Tejjani, Khadija, additional, van Rijswijk, Jacqueline, additional, Bakker, Margreet, additional, van der Hoek, Lia, additional, Schim van der Loeff, Maarten F., additional, van der Valk, Marc, additional, van Gils, Marit J., additional, Kootstra, Neeltje A., additional, Reiss, Peter, additional, Reiss, P., additional, Wit, F. W. N. M., additional, van der Valk, M., additional, Boyd, A., additional, Verburgh, M. L., additional, van der Wulp, I. A. J., additional, Vanbellinghen, M. C., additional, van Eeden, C. J., additional, Schim van der Loeff, M. F., additional, Koole, J. C. D., additional, del Grande, L., additional, Agard, I., additional, Zaheri, S., additional, Hillebregt, M. M. J., additional, Ruijs, Y. M. C., additional, Benschop, D. P., additional, el Berkaoui, A., additional, Kootstra, N. A., additional, Harskamp-Holwerda, A. M., additional, Maurer, I., additional, Mangas Ruiz, M. M., additional, Boeser-Nunnink, B. D. N., additional, Starozhitskaya, O. S., additional, van der Hoek, L., additional, Bakker, M., additional, van Gils, M. J., additional, Dol, L., additional, Rongen, G., additional, Geerlings, S. E., additional, Goorhuis, A., additional, Hovius, J. W. R., additional, Nellen, F. J. B., additional, Prins, J. M., additional, van der Poll, T., additional, Wiersinga, W. J., additional, van Vugt, M., additional, de Bree, G., additional, Lemkes, B. A., additional, Spoorenberg, V., additional, van Eden, J., additional, Pijnappel, F. J. J., additional, Weijsenfeld, A., additional, Smalhout, S., additional, Hylkema-van den Bout, I. J., additional, Bruins, C., additional, Spelbrink, M. E., additional, Postema, P. G., additional, Bisschop, P. H. L. T., additional, Dekker, E., additional, van der Velde, N., additional, Franssen, R., additional, Willemsen, J. M. R., additional, Vogt, L., additional, Portegies, P., additional, Geurtsen, G. J., additional, Visser, I., additional, Schadé, A., additional, Nieuwkerk, P. T., additional, van Steenwijk, R. P., additional, Jonkers, R. E., additional, Majoie, C. B. L. M., additional, Caan, M. W. A., additional, van den Born, B. J. H., additional, Stroes, E. S. G., additional, and van Oorspronk, S., additional

Published
2023
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8. Beter antibioticagebruik bij gecompliceerde urineweginfecties

Author

Spoorenberg, V., Hulscher, M. E. J. L., Geskus, R. B., de Reijke, T. M., Opmeer, B. C., Prins, J. M., Geerlings, S. E., Other departments, Amsterdam institute for Infection and Immunity, Amsterdam Public Health, Epidemiology and Data Science, Cancer Center Amsterdam, Urology, Clinical Research Unit, and Infectious diseases

Subjects
humanities
Abstract

To compare the effectiveness of two strategies to improve antibiotic use in patients with a complicated urinary tract infection. Multicentre cluster randomised unblinded trial. The departments of Internal Medicine and Urology from 19 hospitals in the Netherlands took part in this trial. Based on retrospective patient record investigations we performed baseline measurements on the scores of a validated set of quality indicators for antibiotic use in a minimum of 50 patients with a complicated urinary tract infection per department in 2009. A similar post-trial measurement took place in 2012. In 2010 we randomised the hospitals between 2 improvement strategies: a multifaceted strategy that included results of the baseline measurements, education, reminders and assistance with optional improvement interventions, and a competitive feedback strategy, in which the departments only received results of the baseline measurements and non-anonymous results from the other departments in this study arm. The primary outcome measure was improvement of the quality indicator scores. Secondary outcome measures were determinants of improvement of the indicators. (Netherlands Trial Register: NTR1742) RESULTS: The baseline and post-trial measurements were performed on 1,964 patients and 2,027 patients, respectively. Post-trial measurements revealed a significant, but limited, improvement of several indicators compared with baseline measurements. We found no significant difference in improvement between the two strategies for any indicator. The intensity with which the departments implemented improvement strategies was mostly suboptimal, but intensive implementation of a strategy was associated with greater improvement. The effectiveness of both improvement strategies was comparable, but limited. For real improvement in antibiotic use in patients with complicated urinary tract infections, improvement interventions should be developed and applied by local professionals themselves

Published
2016

9. [Better antibiotic use in complicated urinary tract infections; multicentre cluster randomised trial of 2 improvement strategies]

Author

Spoorenberg, V., Hulscher, M. E. J. L., Geskus, Rb, Reijke, Tm, Brent Cornelis Opmeer, Prins, Jm, and Geerlings, Se

Subjects
lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4], humanities
Abstract

Item does not contain fulltext OBJECTIVE: To compare the effectiveness of two strategies to improve antibiotic use in patients with a complicated urinary tract infection. DESIGN: Multicentre cluster randomised unblinded trial. METHOD: The departments of Internal Medicine and Urology from 19 hospitals in the Netherlands took part in this trial. Based on retrospective patient record investigations we performed baseline measurements on the scores of a validated set of quality indicators for antibiotic use in a minimum of 50 patients with a complicated urinary tract infection per department in 2009. A similar post-trial measurement took place in 2012. In 2010 we randomised the hospitals between 2 improvement strategies: a multifaceted strategy that included results of the baseline measurements, education, reminders and assistance with optional improvement interventions, and a competitive feedback strategy, in which the departments only received results of the baseline measurements and non-anonymous results from the other departments in this study arm. The primary outcome measure was improvement of the quality indicator scores. Secondary outcome measures were determinants of improvement of the indicators. (Netherlands Trial Register: NTR1742) RESULTS: The baseline and post-trial measurements were performed on 1,964 patients and 2,027 patients, respectively. Post-trial measurements revealed a significant, but limited, improvement of several indicators compared with baseline measurements. We found no significant difference in improvement between the two strategies for any indicator. The intensity with which the departments implemented improvement strategies was mostly suboptimal, but intensive implementation of a strategy was associated with greater improvement. CONCLUSION: The effectiveness of both improvement strategies was comparable, but limited. For real improvement in antibiotic use in patients with complicated urinary tract infections, improvement interventions should be developed and applied by local professionals themselves.

Published
2016

10. Improving antibiotic use for complicated urinary tract infections

Author

Spoorenberg, V., Prins, Jan M., Hulscher, M. E. J. L., Geerlings, Suzanne E., Other departments, Prins, J.M., Hulscher, M.E.J.L., Geerlings, S.E., and Faculteit der Geneeskunde

Abstract

Guidelines for antimicrobial treatment are important in the process of improving antibiotic use, because they describe appropriate antibiotic use. In this thesis, we demonstrated the value of appropriate antibiotic use (i.e. guideline adherence) in patients with a complicated urinary tract infection (UTI), one of the most prevalent infectious diseases in hospital. Appropriate antibiotic use increases bacterial coverage rates without prescribing unnecessarily broad regimens, which is beneficial for containment of bacterial resistance. Furthermore, appropriate antibiotic use seems to reduce length of hospital stay by more than 2 days and therefore favours patient outcome and health care costs. In current practice, a large variation was shown between departments in the appropriateness of antibiotic use for patients with a complicated UTI. This was to some extent determined by patient characteristics, and only to a limited extent by department or hospital characteristics. No single antibiotic stewardship elements were consistently associated with appropriate antibiotic use. We compared the effectiveness of two different strategies to improve the appropriateness antibiotic use in patients with a complicated UTI. We found that the effectiveness of both strategies was comparable and that better compliance with the strategies was associated with more improvement. Our study emphasize the need for a locally multidisciplinary team of engaged professionals to initiate improvement interventions, as recommended in antimicrobial stewardship programs. Future improvement initiatives should aim to decrease inter-department variation in appropriateness of antibiotic use by focusing on departments with poor baseline performance, as low baseline performance was associated with a larger effect of improvement strategies.

Published
2014

11. A Cluster-Randomized Trial of Two Strategies to Improve Antibiotic Use for Patients with a Complicated Urinary Tract Infection

Author

Spoorenberg, V., Hulscher, M.E.J.L., Geskus, R.B., Reijke, T.M. de, Opmeer, B.C., Prins, J.M., Geerlings, S.E., Spoorenberg, V., Hulscher, M.E.J.L., Geskus, R.B., Reijke, T.M. de, Opmeer, B.C., Prins, J.M., and Geerlings, S.E.

Abstract

Contains fulltext : 152505.PDF (publisher's version ) (Open Access), BACKGROUND: Up to 50% of hospital antibiotic use is inappropriate and therefore improvement strategies are urgently needed. We compared the effectiveness of two strategies to improve the quality of antibiotic use in patients with a complicated urinary tract infection (UTI). METHODS: In a multicentre, cluster-randomized trial 19 Dutch hospitals (departments Internal Medicine and Urology) were allocated to either a multi-faceted strategy including feedback, educational sessions, reminders and additional/optional improvement actions, or a competitive feedback strategy, i.e. providing professionals with non-anonymous comparative feedback on the department's appropriateness of antibiotic use. Retrospective baseline- and post-intervention measurements were performed in 2009 and 2012 in 50 patients per department, resulting in 1,964 and 2,027 patients respectively. Principal outcome measures were nine validated guideline-based quality indicators (QIs) that define appropriate antibiotic use in patients with a complicated UTI, and a QI sumscore that summarizes for each patient the appropriateness of antibiotic use. RESULTS: Performance scores on several individual QIs showed improvement from baseline to post-intervention measurements, but no significant differences were found between both strategies. The mean patient's QI sum score improved significantly in both strategy groups (multi-faceted: 61.7% to 65.0%, P = 0.04 and competitive feedback: 62.8% to 66.7%, P = 0.01). Compliance with the strategies was suboptimal, but better compliance was associated with more improvement. CONCLUSION: The effectiveness of both strategies was comparable and better compliance with the strategies was associated with more improvement. To increase effectiveness, improvement activities should be rigorously applied, preferably by a locally initiated multidisciplinary team. TRIAL REGISTRATION: Nederlands Trial Register 1742.

Published
2015

12. Appropriate antibiotic use for patients with complicated urinary tract infections in 38 Dutch Hospital Departments: a retrospective study of variation and determinants

Author

Spoorenberg, V., Geerlings, S.E., Geskus, R.B., Reijke, T.M. de, Prins, J.M., Hulscher, M.E.J.L., Spoorenberg, V., Geerlings, S.E., Geskus, R.B., Reijke, T.M. de, Prins, J.M., and Hulscher, M.E.J.L.

Abstract

Contains fulltext : 152794.pdf (publisher's version ) (Open Access), BACKGROUND: Appropriate antibiotic use in patients with complicated urinary tract infections can be measured by a valid set of nine quality indicators (QIs). We evaluated the performance of these QIs in a national setting and investigated which determinants influenced appropriate antibiotic use. For the latter, we distinguished patient, department and hospital characteristics, including organizational interventions aimed at improving the quality of antibiotic use (antibiotic stewardship elements). METHODS: A retrospective, observational multicentre study included 1964 patients (58 % male sex) with a complicated urinary tract infection treated at Internal Medicine and Urology departments of 19 Dutch university and non-university hospitals. Data of 50 patients per department were extracted from medical charts. QI performance scores were calculated using previously constructed algorithms. Department and hospital characteristics were collected using questionnaires filled in by an internal medicine physician and an urologist. Regression analysis was performed to identify determinants of QI performance. Clustering at department and hospital level was taken into account through inclusion of random effects in a multi-level model. RESULTS: Median QI performance of departments varied between 31 % ('Treat urinary tract infection in men according to local guideline') and 77 % ('Perform urine culture'). The patient characteristics non-febrile urinary tract infection, female sex and presence of a urinary catheter were negatively associated with performance on many QIs. The presence of an infectious diseases physician and an antibiotic formulary were positively associated with 'Prescribe empirical therapy according to guideline'. No other department or hospital characteristics, including stewardship elements, were consistently associated with better QI performance. CONCLUSIONS: A large inter-department variation was demonstrated in the appropriateness of antibiotic use. In particu

Published
2015

14. Appropriate antibiotic use for patients with urinary tract infections reduces length of hospital stay

Author

Spoorenberg, V., Hulscher, M.E.J.L., Akkermans, R.P., Prins, J.M., Geerlings, S.E., Spoorenberg, V., Hulscher, M.E.J.L., Akkermans, R.P., Prins, J.M., and Geerlings, S.E.

Abstract

Item does not contain fulltext, BACKGROUND: To define appropriate antibiotic use for patients with a complicated urinary tract infection (UTI), we developed in a previous study a key set of 4 valid, guideline-based quality indicators (QIs). In the current study, we evaluated the association between appropriate antibiotic use for patients with a complicated UTI, as defined by these QIs, and length of hospital stay (LOS). METHODS: A retrospective, observational multicenter study included 1252 patients with a complicated UTI, hospitalized at internal medicine and urology departments of 19 university and nonuniversity Dutch hospitals. Data from the patients' medical charts were used to calculate QI performance scores. Multilevel mixed-model analyses were performed to relate LOS to QI performance (appropriate use or not). We controlled for the potential confounders sex, age, (urological) comorbidity, febrile UTI, and intensive care unit admission <24 hours. RESULTS: Prescribing therapy in accordance with local hospital guidelines was associated with a shorter LOS (7.3 days vs 8.7 days; P = .02), as was early intravenous-oral switching (4.8 days vs 9.1 days; P < .001). There was an inverse relationship between the proportion of appropriate use in a patient (QI sum score/number of applicable QIs) and LOS (9.3 days for lower tertile vs 7.2 days for upper tertile; overall P < .05). CONCLUSIONS: Appropriate antibiotic use in patients with a complicated UTI seems to reduce length of hospital stay and therefore favors patient outcome and healthcare costs. In particular, adherence to the total set of QIs showed a significant dose-response relationship with a shorter LOS.

Published
2014

17. The Utility of Risk Factors to Define Complicated Staphylococcus aureus Bacteremia in a Setting With Low Methicillin-Resistant S. aureus Prevalence.

Author

van der Vaart TW, Prins JM, Goorhuis A, Lemkes BA, Sigaloff KCE, Spoorenberg V, Stijnis C, Bonten MJM, and van der Meer JTM

Subjects
Humans, Methicillin Resistance, Staphylococcus aureus, Prospective Studies, Prevalence, Risk Factors, Anti-Bacterial Agents therapeutic use, Anti-Bacterial Agents pharmacology, Methicillin-Resistant Staphylococcus aureus, Bacteremia drug therapy, Bacteremia epidemiology, Staphylococcal Infections drug therapy, Staphylococcal Infections epidemiology
Abstract

Introduction: Recommended duration of antibiotic treatment of Staphylococcus aureus bacteremia (SAB) is frequently based on distinguishing uncomplicated and complicated SAB, and several risk factors at the onset of infection have been proposed to define complicated SAB. Predictive values of risk factors for complicated SAB have not been validated, and consequences of their use on antibiotic prescriptions are unknown., Methods: In a prospective cohort, patients with SAB were categorized as complicated or uncomplicated through adjudication (reference definition). Associations and predictive values of 9 risk factors were determined, compared with the reference definition, as was accuracy of Infectious Diseases Society of America (IDSA) criteria that include 4 risk factors, and the projected consequences of applying IDSA criteria on antibiotic use., Results: Among 490 patients, 296 (60%) had complicated SAB. In multivariable analysis, persistent bacteremia (odds ratio [OR], 6.8; 95% confidence interval [CI], 3.9-12.0), community acquisition of SAB (OR, 2.9; 95% CI, 1.9-4.7) and presence of prosthetic material (OR, 2.3; 95% CI, 1.5-3.6) were associated with complicated SAB. Presence of any of the 4 risk factors in the IDSA definition of complicated SAB had a positive predictive value of 70.9% (95% CI, 65.5-75.9) and a negative predictive value of 57.5% (95% CI, 49.1-64.8). Compared with the reference, IDSA criteria yielded 24 (5%) false-negative and 90 (18%) false-positive classifications of complicated SAB. Median duration of antibiotic treatment of these 90 patients was 16 days (interquartile range, 14-19), all with favorable clinical outcome., Conclusions: Risk factors have low to moderate predictive value to identify complicated SAB and their use may lead to unnecessary prolonged antibiotic use., Competing Interests: Potential conflicts of interest. M. J. B. reports funding from Janssen Vaccines, Novartis, CureVac, Merck, Takeda, Sanofi, Spherecydes, Pfizer, and AstraZeneca for unrelated works. C. H. W. reports funding from DaVolterra, bioMérieux, LimmaTech, Merck/MSD, and Sanofi-Pasteur for unrelated works. A. G. reports Netherlands Government Grants paid to Amsterdam UMC (2021: Government grant to investigate COVID-19 vaccine immunogenicity for hematological patients and 2021: Government grant to investigate heterologous COVID-19 vaccination strategies in healthcare workers) and speaker fees from Springer Healthcare (2023: invited speaker on infectious diseases), all for work unrelated to this project. M. B. reports grants from Janssen Vaccines and Merck, consulting fees from Merck, Shionogi, and Spherecydes, and participation on a Data Safety Monitoring Board or Advisory Board for Sanofi all for work unrelated to this project and paid to UMC Utrecht. B. A. L. reports a role as Member of Supervisory Board Orange Babies Charity. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed., (© The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America.)

Published
2024
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18. [Better antibiotic use in complicated urinary tract infections; multicentre cluster randomised trial of 2 improvement strategies].

Author

Spoorenberg V, Hulscher ME, Geskus RB, de Reijke TM, Opmeer BC, Prins JM, and Geerlings SE

Subjects
Adult, Female, Hospitals, Humans, Male, Middle Aged, Netherlands, Patient Satisfaction, Retrospective Studies, Surveys and Questionnaires, Urinary Tract Infections complications, Urinary Tract Infections prevention & control, Anti-Bacterial Agents therapeutic use, Quality Indicators, Health Care, Urinary Tract Infections drug therapy
Abstract

Objective: To compare the effectiveness of two strategies to improve antibiotic use in patients with a complicated urinary tract infection., Design: Multicentre cluster randomised unblinded trial., Method: The departments of Internal Medicine and Urology from 19 hospitals in the Netherlands took part in this trial. Based on retrospective patient record investigations we performed baseline measurements on the scores of a validated set of quality indicators for antibiotic use in a minimum of 50 patients with a complicated urinary tract infection per department in 2009. A similar post-trial measurement took place in 2012. In 2010 we randomised the hospitals between 2 improvement strategies: a multifaceted strategy that included results of the baseline measurements, education, reminders and assistance with optional improvement interventions, and a competitive feedback strategy, in which the departments only received results of the baseline measurements and non-anonymous results from the other departments in this study arm. The primary outcome measure was improvement of the quality indicator scores. Secondary outcome measures were determinants of improvement of the indicators. (Netherlands Trial Register: NTR1742) RESULTS: The baseline and post-trial measurements were performed on 1,964 patients and 2,027 patients, respectively. Post-trial measurements revealed a significant, but limited, improvement of several indicators compared with baseline measurements. We found no significant difference in improvement between the two strategies for any indicator. The intensity with which the departments implemented improvement strategies was mostly suboptimal, but intensive implementation of a strategy was associated with greater improvement., Conclusion: The effectiveness of both improvement strategies was comparable, but limited. For real improvement in antibiotic use in patients with complicated urinary tract infections, improvement interventions should be developed and applied by local professionals themselves.

Published
2016

19. A Cluster-Randomized Trial of Two Strategies to Improve Antibiotic Use for Patients with a Complicated Urinary Tract Infection.

Author

Spoorenberg V, Hulscher ME, Geskus RB, de Reijke TM, Opmeer BC, Prins JM, and Geerlings SE

Subjects
Adult, Aged, Aged, 80 and over, Feedback, Female, Humans, Male, Middle Aged, Netherlands, Practice Guidelines as Topic, Quality Indicators, Health Care, Retrospective Studies, Urinary Tract Infections complications, Anti-Bacterial Agents therapeutic use, Urinary Tract Infections drug therapy
Abstract

Background: Up to 50% of hospital antibiotic use is inappropriate and therefore improvement strategies are urgently needed. We compared the effectiveness of two strategies to improve the quality of antibiotic use in patients with a complicated urinary tract infection (UTI)., Methods: In a multicentre, cluster-randomized trial 19 Dutch hospitals (departments Internal Medicine and Urology) were allocated to either a multi-faceted strategy including feedback, educational sessions, reminders and additional/optional improvement actions, or a competitive feedback strategy, i.e. providing professionals with non-anonymous comparative feedback on the department's appropriateness of antibiotic use. Retrospective baseline- and post-intervention measurements were performed in 2009 and 2012 in 50 patients per department, resulting in 1,964 and 2,027 patients respectively. Principal outcome measures were nine validated guideline-based quality indicators (QIs) that define appropriate antibiotic use in patients with a complicated UTI, and a QI sumscore that summarizes for each patient the appropriateness of antibiotic use., Results: Performance scores on several individual QIs showed improvement from baseline to post-intervention measurements, but no significant differences were found between both strategies. The mean patient's QI sum score improved significantly in both strategy groups (multi-faceted: 61.7% to 65.0%, P = 0.04 and competitive feedback: 62.8% to 66.7%, P = 0.01). Compliance with the strategies was suboptimal, but better compliance was associated with more improvement., Conclusion: The effectiveness of both strategies was comparable and better compliance with the strategies was associated with more improvement. To increase effectiveness, improvement activities should be rigorously applied, preferably by a locally initiated multidisciplinary team., Trial Registration: Nederlands Trial Register 1742.

Published
2015
Full Text
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20. Appropriate antibiotic use for patients with urinary tract infections reduces length of hospital stay.

Author

Spoorenberg V, Hulscher ME, Akkermans RP, Prins JM, and Geerlings SE

Subjects
Adult, Aged, Aged, 80 and over, Cohort Studies, Humans, Male, Middle Aged, Netherlands, Retrospective Studies, Anti-Bacterial Agents therapeutic use, Length of Stay statistics & numerical data, Urinary Tract Infections drug therapy
Abstract

Background: To define appropriate antibiotic use for patients with a complicated urinary tract infection (UTI), we developed in a previous study a key set of 4 valid, guideline-based quality indicators (QIs). In the current study, we evaluated the association between appropriate antibiotic use for patients with a complicated UTI, as defined by these QIs, and length of hospital stay (LOS)., Methods: A retrospective, observational multicenter study included 1252 patients with a complicated UTI, hospitalized at internal medicine and urology departments of 19 university and nonuniversity Dutch hospitals. Data from the patients' medical charts were used to calculate QI performance scores. Multilevel mixed-model analyses were performed to relate LOS to QI performance (appropriate use or not). We controlled for the potential confounders sex, age, (urological) comorbidity, febrile UTI, and intensive care unit admission <24 hours., Results: Prescribing therapy in accordance with local hospital guidelines was associated with a shorter LOS (7.3 days vs 8.7 days; P = .02), as was early intravenous-oral switching (4.8 days vs 9.1 days; P < .001). There was an inverse relationship between the proportion of appropriate use in a patient (QI sum score/number of applicable QIs) and LOS (9.3 days for lower tertile vs 7.2 days for upper tertile; overall P < .05)., Conclusions: Appropriate antibiotic use in patients with a complicated UTI seems to reduce length of hospital stay and therefore favors patient outcome and healthcare costs. In particular, adherence to the total set of QIs showed a significant dose-response relationship with a shorter LOS.

Published
2014
Full Text
View/download PDF

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