Intervention Study to Improve Antibiotic Prescription in Outpatient Care

NCT ID: NCT01358916

Last Updated: 2013-03-29

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

Total Enrollment

140 participants

Study Classification

INTERVENTIONAL

Study Start Date

2010-11-30

Study Completion Date

2012-12-31

Brief Summary

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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.

Detailed Description

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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.

Conditions

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Respiratory Tract Infections Urinary Tract Infections

Keywords

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antimicrobial resistance antibiotic prescription primary health care cluster-randomized trial

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Blinding Strategy

NONE

Study Groups

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Usual information policy

No specific intervention

Group Type NO_INTERVENTION

No interventions assigned to this group

Antibiotic therapy guidelines

Group Type OTHER

Mailing of antibiotic therapy guidelines to the sentinel physicians

Intervention Type OTHER

Mailing of antibiotic therapy guidelines to the sentinel physicians and regular feedback on antibiotic prescription

Interventions

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Mailing of antibiotic therapy guidelines to the sentinel physicians

Mailing of antibiotic therapy guidelines to the sentinel physicians and regular feedback on antibiotic prescription

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Patients with respiratory tract infections or urinary tract infections

Exclusion Criteria

* Patients with chronic disease requiring regular antibiotic treatment
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Bundesamt für Gesundheit

UNKNOWN

Sponsor Role collaborator

Sentinella Netzwerk

UNKNOWN

Sponsor Role collaborator

Schweizerische Gesellschaft für Infektiologie

UNKNOWN

Sponsor Role collaborator

Pädiatrische Infektiologie Gruppe Schweiz

UNKNOWN

Sponsor Role collaborator

University of Bern

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Andreas Kronenberg, Dr. med.

Role: PRINCIPAL_INVESTIGATOR

University of Bern

Locations

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Institute for Infectious Diseases

Bern, , Switzerland

Site Status

Countries

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Switzerland

References

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Hurlimann D, Limacher A, Schabel M, Zanetti G, Berger C, Muhlemann K, Kronenberg A; Swiss Sentinel Working Group. Improvement of antibiotic prescription in outpatient care: a cluster-randomized intervention study using a sentinel surveillance network of physicians. J Antimicrob Chemother. 2015 Feb;70(2):602-8. doi: 10.1093/jac/dku394. Epub 2014 Oct 17.

Reference Type DERIVED
PMID: 25326088 (View on PubMed)

Other Identifiers

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Swiss Federal Office of Health

Identifier Type: -

Identifier Source: org_study_id