The Impact of an Antimicrobial Utilization Program on Antimicrobial Use
Multidisciplinary antimicrobial utilization teams (AUT) have been proposed as an effective mechanism for improving antimicrobial use, but data on their efficacy remain limited. The researchers postulated that a multi-disciplinary AUT would improve antimicrobial use in a teaching hospital when compared to the standard of care (no AUT intervention).
Design: Randomized-controlled intervention trial. Setting: A 953-bed urban teaching hospital.
Patients: Patients admitted to internal medicine ward teams who were prescribed selected antimicrobial agents (piperacillin-tazobactam, levofloxacin, or vancomycin) during the 10month study period.
Intervention: Eight internal medicine ward teams were randomized monthly to academic detailing by the AUT while 8 internal medicine ward teams were randomized indication-based prescription of broad spectrum antimicrobials.
Measurements: Proportion of appropriate empiric, definitive, and end antimicrobial usage (antimicrobial use from the initiation of therapy until definitive therapy is prescribed).
|Antimicrobial Prescribing Practices||Behavioral: Academic Detailing by the Antimicrobial Utilization Team (AUT)|
|Study Design:||Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single Blind (Outcomes Assessor)
|Official Title:||The Impact of an Antimicrobial Utilization Program on Antimicrobial Use in a Large Public Hospital: A Randomized Controlled Trial|
- Proportion of Appropriateness of Antimicrobial Prescriptions in each group. [ Time Frame: 10-month period ]
- Clinical Cure Rate, Mortality Rate between the two groups [ Time Frame: 10-month period ]
|Study Start Date:||October 2002|
|Study Completion Date:||August 2003|
No Intervention: A
Physicians in this arm did not have any intervention with the AUT. Antimicrobial prescriptions were based on hospital guidelines or on the physician's medical knowledge.
Behavioral: Academic Detailing by the Antimicrobial Utilization Team (AUT)
Physicians caring for patients who were prescribed one of three antimicrobials were randomly assigned to academic detailing by the AUT. The AUT would review the antimicrobial prescription and provide consultation to the ordering physician if the prescription is appropriate and provide feedback on a better alternative if inappropriate.
Please refer to this study by its ClinicalTrials.gov identifier: NCT00552838
|United States, Georgia|
|Grady Memorial Hospital|
|Atlanta, Georgia, United States, 30303|
|Principal Investigator:||Mark D King, MD, MSCR||Emory University|