Antimicrobial Stewardship in UTIs in Nursing Homes
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|ClinicalTrials.gov Identifier: NCT04798365|
Recruitment Status : Recruiting
First Posted : March 15, 2021
Last Update Posted : March 15, 2021
Background: The widespread inappropriate use of antimicrobial substances drives resistance development at the individual and population level all over the world. In long-term care facilities (LTCF), antibiotics are among the most frequently prescribed medications. More than one third of antibiotics prescribed in LTCFs are for urinary tract infections (UTI). Studies have shown that 30 - 40% of antibiotic courses prescribed in LTCFs were unnecessary and that more than two-thirds were inappropriate based on society guidelines.
Preliminary data: A surveillance study on healthcare-associated UTIs at LTCFs of the Geriatric Health Centers Graz revealed that guideline recommendations on antimicrobial choice were met in only 50% of patients. The most frequently used antimicrobial substances for UTI were quinolones.
Aims: Using a multifaceted bundle of antimicrobial stewardship interventions consisting of clinical practice guidelines, care pathways and local as well as web-based education and training targeting nursing staff as well as physicians we aim to improve the quality of antimicrobial prescriptions for UTIs in four LTCFs in Graz, Austria.
Design: Non-randomized cluster controlled intervention study. Setting: The Geriatric Health Centers Graz are a local institution comprising among others 4 LTCFs (total of 400 beds). These will serve as intervention group. Four LTCFs located in the surroundings of Graz will serve as control group.
Intervention: The main components of the intervention are 1) two sessions of voluntary continuing medical education on the urinary tract infection program in each LTCF for physicians and nursing staff, 2) distribution of educations materials such as written guidelines on antibiotic prescribing including a smart phone friendly version, 3) implementation of the project homepage as a platform to distribute guidelines and educational videos and to enable physicians to ask questions which will be answered by an infectious disease physician.
Outcomes: The primary outcome will be the proportion of adequate prescriptions (adequate in terms of antimicrobial choice). Secondary outcomes include proportion of adequate prescriptions (adequate in terms of decision to treat), number of cases with clinical failure, number of admissions to hospital due to UTI, number of adverse events attributed to antimicrobial treatment for UTI, percentage of extended spectrum betalactamase (ESBL) producing enterobacteria isolated from urinary cultures
|Condition or disease||Intervention/treatment||Phase|
|Urinary Tract Infections||Behavioral: Intervention group||Not Applicable|
|Study Type :||Interventional (Clinical Trial)|
|Estimated Enrollment :||306 participants|
|Intervention Model:||Parallel Assignment|
|Masking:||Single (Outcomes Assessor)|
|Official Title:||Implementation of an Antimicrobial Stewardship Program Targeting Residents With Urinary Tract Infections in Long-term Care Facilities|
|Actual Study Start Date :||March 1, 2021|
|Estimated Primary Completion Date :||December 2022|
|Estimated Study Completion Date :||December 2022|
Experimental: Intervention group
The main components of the intervention are 1) two sessions of voluntary continuing medical education on the urinary tract infection program in each LTCF for physicians and nursing staff, 2) distribution of educations materials such as written guidelines on antibiotic prescribing including a smart phone friendly version, 3) implementation of the project homepage as a platform to distribute guidelines and educational videos and to enable physicians to ask questions which will be answered by an infectious disease physician.
Behavioral: Intervention group
medical education and distribution of educations materials
No Intervention: Control group
No intervention until end of the stuy.
- proportion of adequate prescriptions (adequate in terms of antimicrobial choice) [ Time Frame: 2 weeks ]
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT04798365
|Contact: Ines Zollner-Schwetz, MD||+43 316 385 ext email@example.com|
|Fehring, Austria, 8350|
|Contact: Sonja Dolzer +43 3155 5175 firstname.lastname@example.org|
|Geriatric Health Centres of the City of Graz||Recruiting|
|Graz, Austria, 8010|
|Contact: Christian Pux +43 316 7060 email@example.com|
|Graz, Austria, 8010|
|Contact: Irmina Gerlich, MA 43 316 8960 ext 79 025 firstname.lastname@example.org|
|Bezirkspflege-und Seniorenheim Voitsberg||Recruiting|
|Voitsberg, Austria, 8570|
|Contact: Christine Kollmuetzer +43 3155 5175 email@example.com|