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Optimizing Antibiotic Use in Long Term Care

NCT ID: NCT00243360

Last Updated: 2005-10-24

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Study Classification

INTERVENTIONAL

Study Start Date

2001-01-31

Study Completion Date

2003-07-31

Brief Summary

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The purpose of this study was to determine if a multi-faceted intervention to implement diagnostic and therapeutic algorithms for management of suspected urinary infection in nursing home residents could reduce antibiotic prescribing for urinary indications in this population.

Detailed Description

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Antibiotic use is intense in nursing homes and frequently inappropriate when prescribed for urinary indications. Evidence from randomized controlled trials suggests that treatment of asymptomatic bacteriuria, the presence of bacteria in the urine in the absence of urinary symptoms, is not beneficial. Despite this, one in three prescriptions for urinary indications are for asymptomatic bacteriuria. To improve antibiotic prescribing in this setting we conducted a cluster randomized trial of a strategy to implement diagnostic and treatment algorithms for urinary infection. 24 nursing homes were randomized to either the intervention (implemented at the nursing home level using a multi-faceted approach: small group interactive sessions for nurses, one-on-one interviews for physicians, videotapes, written material, and outreach visits) or to usual care.

Conditions

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Urinary Tract Infection, Antibiotic Use

Keywords

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Urinary tract infections, antibiotic use, long term care facilities

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

ECT

Blinding Strategy

NONE

Interventions

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diagnostic and treatment clinical algorithms

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

1. Individuals- all residents eligible
2. Nursing homes

* Free standing long term care facilities with \>100 beds
* No stated policy for diagnosis or treatment of urinary tract infections
* The facility agrees to refrain from introducing new strategies for antibiotic utilization or clinical pathways during study

Exclusion Criteria

\-
Minimum Eligible Age

0 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Agency for Healthcare Research and Quality (AHRQ)

FED

Sponsor Role lead

Principal Investigators

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Mark B Loeb, MD MSc FRCPC

Role: PRINCIPAL_INVESTIGATOR

McMaster University

Locations

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McMaster University

Hamilton, Ontario, Canada

Site Status

Countries

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Canada

Other Identifiers

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U18HS011113-01

Identifier Type: AHRQ

Identifier Source: org_study_id

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