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Optimizing Antibiotic Use in Long Term Care

This study has been completed.
Information provided by:
Agency for Healthcare Research and Quality (AHRQ) Identifier:
First received: October 21, 2005
Last updated: NA
Last verified: October 2005
History: No changes posted
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.

Condition Intervention
Urinary Tract Infection, Antibiotic Use Behavioral: diagnostic and treatment clinical algorithms

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Educational/Counseling/Training
Official Title: Optimizing Antibiotic Use in Long Term Care

Resource links provided by NLM:

Further study details as provided by Agency for Healthcare Research and Quality (AHRQ):

Primary Outcome Measures:
  • Antimicrobial prescriptions

Secondary Outcome Measures:
  • Urinary cultures,
  • hospitalizations, deaths

Study Start Date: January 2001
Estimated Study Completion Date: July 2003
Detailed Description:
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.

Ages Eligible for Study:   Child, Adult, Senior
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

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:

  Contacts and Locations
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Please refer to this study by its identifier: NCT00243360

Canada, Ontario
McMaster University
Hamilton, Ontario, Canada, L8N 3Z5
Sponsors and Collaborators
Agency for Healthcare Research and Quality (AHRQ)
Principal Investigator: Mark B Loeb, MD MSc FRCPC McMaster University
  More Information Identifier: NCT00243360     History of Changes
Other Study ID Numbers: U18HS011113-01 ( U.S. AHRQ Grant/Contract )
Study First Received: October 21, 2005
Last Updated: October 21, 2005

Keywords provided by Agency for Healthcare Research and Quality (AHRQ):
Urinary tract infections,
antibiotic use,
long term care facilities

Additional relevant MeSH terms:
Urinary Tract Infections
Urologic Diseases
Anti-Bacterial Agents
Antibiotics, Antitubercular
Anti-Infective Agents
Antitubercular Agents processed this record on September 21, 2017