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Intervention Study to Improve Antibiotic Prescription in Outpatient Care

Information source: University of Bern
ClinicalTrials.gov processed this data on August 23, 2015
Link to the current ClinicalTrials.gov record.

Condition(s) targeted: Respiratory Tract Infections; Urinary Tract Infections

Intervention: Mailing of antibiotic therapy guidelines to the sentinel physicians (Other)

Phase: N/A

Status: Completed

Sponsored by: University of Bern

Official(s) and/or principal investigator(s):
Andreas Kronenberg, Dr. med., Principal Investigator, Affiliation: University of Bern

Summary

Antimicrobial resistance has become a world-wide problem and antibiotic consumption is a major driving force for the development of resistance. Thus optimization of antibiotic prescription and reduction of unnecessary antimicrobial treatment are essential in the prevention and reduction of antimicrobial resistance rates. The goal of this study is the improvement of antibiotic prescription in outpatient care. The study will take place within a Swiss-wide sentinel surveillance network of physicians. The participating physicians will be randomised in a control and intervention group. The intervention group will receive therapeutic guidelines for the treatment of upper and lower respiratory tract infections and lower urinary tract infection as well as regular feed-backs on the prescription pattern of the sentinel physicians during the past months. Sentinel physicians will collect information about each antibiotic prescription, its indication and characteristics of the patient. Our hypothesis is that the prescription pattern in the intervention group will be optimised and unnecessary antibiotic therapy will be reduced compared to the control group.

Clinical Details

Official title: Improvement of Antibiotic Prescription in Outpatient Care: a Cluster-randomised Intervention Study Using a Sentinel Surveillance Network of Physicians

Study design: Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Open Label

Primary outcome:

Percentage of prescriptions of penicillin for respiratory tract infections

Percentage of prescriptions of TMP/SMX for lower urinary tract infections in adults

Secondary outcome:

Percentage of prescriptions of quinolone for COPD exacerbations in adults

Percentage of antibiotic prescriptions for the indications "sinusitis" and "other upper respiratory tract infections"

Detailed description: Background Antimicrobial resistance has become a world-wide problem and antibiotic consumption is a major driving force for the development of resistance. Thus optimization of antibiotic prescription and reduction of unnecessary antimicrobial treatment are essential in the prevention and reduction of antimicrobial resistance rates. The goal of this study is the qualitative and quantitative improvement of antibiotic prescription in outpatient care. The study will take place within a Swiss-wide sentinel surveillance network consisting of general practitioners, pediatricians and physicians specialized in internal medicine. The participating physicians will be randomised in a control and intervention group. The intervention group will receive therapeutic guidelines for the treatment of upper and lower respiratory tract infections and lower urinary tract infections. Furthermore, regular feed-backs on the prescription pattern of the sentinel physicians in the last months will be provided. Information about each antibiotic prescription, its indication and the characteristics of the patients will be collected by the sentinel physicians. The standardized reporting of antibiotic prescription by sentinel physicians has been carried out in Switzerland since 2006. Our hypothesis is that the intervention will affect the antibiotic prescription pattern and that the investigators will observe an optimization of antibiotic prescription and a decrease in the number of antibiotic prescriptions. Objective Primary goals:

- Increase of the percentage of penicillin prescriptions for upper and lower respiratory

tract infections

- Increase of the percentage of TMP/SMX prescriptions for lower urinary tract infections

in adults Secondary goal:

- Decrease of the percentage of quinolone prescriptions for COPD exacerbations in adults

- Decrease of the number of antibiotic prescriptions for sinusitis and other upper

respiratory tract infections Methods Prospective cluster-randomised intervention study. The intervention is the mailing of treatment guidelines for upper and lower respiratory tract infections and lower urinary tract infections as well as regular feed-backs on the antibiotic prescription patterns of the sentinel physicians during the past months.

Eligibility

Minimum age: N/A. Maximum age: N/A. Gender(s): Both.

Criteria:

Inclusion Criteria:

- Patients with respiratory tract infections or urinary tract infections

Exclusion Criteria

- Patients with chronic disease requiring regular antibiotic treatment

Locations and Contacts

Institute for Infectious Diseases, Bern 3010, Switzerland
Additional Information

Starting date: November 2010
Last updated: March 27, 2013

Page last updated: August 23, 2015

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