Israeli Judicious Antibiotic Prescription Study (IJAP)

This study has been completed.
Maccabi Healthcare Services, Israel
Information provided by:
Sheba Medical Center Identifier:
First received: August 23, 2010
Last updated: NA
Last verified: August 2010
History: No changes posted
This study aims to implement judicious antibiotic prescription habits to primary care pediatricians using a multifacet educational intervention and assess two main outcomes: 1) Direct outcome - prescription rates of the physicians. 2)Indirect outcome - carriage of antibiotic resistant bacteria by the treated population, specifically nasopharyngeal S. pneumoniae, nasal S. aureus and rectal E.coli.

Condition Intervention
Antibiotic Use
Carriage of Antibiotic Resistant Pathogens
Behavioral: Workshops and focus group meetings

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Prevention
Official Title: Can Change in Physicians' Prescribing Habits Decrease Carriage of Resistant Bacteria in the Community?

Resource links provided by NLM:

Further study details as provided by Sheba Medical Center:

Primary Outcome Measures:
  • antibiotic prescription rate of physicians [ Time Frame: 5 years ] [ Designated as safety issue: No ]
    Antibiotic prescrption rate at baseline will be compared to changes following the intervention between the 2 groups (control and intervention).

Secondary Outcome Measures:
  • Carriage of antibiotic resistant bacteria by treated patients [ Time Frame: 4 years ] [ Designated as safety issue: No ]
    Every summer and winter a crosssectional survey of the treated patients of the control and intervention physicians will be carried out to determine the rate of carriage of penicillin-resistant S. pneumonaie, MRSA and Quinolone-resistant E.coli.

Enrollment: 5700
Study Start Date: February 2002
Study Completion Date: December 2007
Primary Completion Date: October 2005 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Educational intervention
Multifacet educational intervention that includes workshops, seminars and focus group meetings
Behavioral: Workshops and focus group meetings
Multifacet intervention that includes: Guideline preparation and implementation, preparing clinic campaign, improving knowledge about Ab resistance and diagnosis of respiratory infections
No Intervention: Control - no intervention
This group did not have any intervention, but their population was screened for carriage of antibiotic resistant bacteria

Detailed Description:

Background: Bacterial antibiotic resistance is an increasing problem.

Aims: This study aims to implement judicious antibiotic prescription habits among 30 physicians and their treated population as compared to a control group of 30 physicians and their treated population. The outcomes to be measured are:

  1. Change in antibiotic prescriptions to the treated patients of the intervention vs. control physicians during the study period (4years).
  2. Change in carriage of antibiotic resistant pathogens, specifically nasopharyngeal penicillin resistant S. pneumoniae,nasal MRSA, and rectal quinolone resistant E. coli.

Study design: All primary care pediatricians of Hashfela district of Macabbi Healthcare services who will agree to participate will be randomly assigned to an intervention or control group. The intervention group will be led by local leaders (primary care physicians from that district) and will take part in educational activities involving annual workshops and quarterly focus group meetings. The intervention is a multifacet intervention that will include guideline preparation, knowledge building, dealing with uncertainties, etc.

The patients of both intervention and control physicians will be screened twice a year for carriage of the bacteria mentioned above. Cross-sectional screening of the treated population will be carried in Summer and winter for 5 consecutive years. Screening will include signing an informed consent, filling a questionnaire and screening with nasal, nasopharyngeal and rectal swabs.


Ages Eligible for Study:   up to 5 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   Yes

Inclusion Criteria:

  • All treated patients of the participating physicians under the age of 5y, who came for any reason for a visit during the study period, who's parents agreed to participate.

Exclusion Criteria:

The only reason to exclude a child from being recruited was age>5y or refusal of the parent/child to participate.

  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

No Contacts or Locations Provided
  More Information

No publications provided by Sheba Medical Center

Additional publications automatically indexed to this study by Identifier (NCT Number):
Responsible Party: Gili Regev-Yochay, Sheba medical Center Identifier: NCT01187758     History of Changes
Other Study ID Numbers: SHEBA-01-2357-GRY-CTIL 
Study First Received: August 23, 2010
Last Updated: August 23, 2010
Health Authority: Israel: Israeli Health Ministry Pharmaceutical Administration

Keywords provided by Sheba Medical Center:
antibiotic use
antibiotic prescription
antibiotic resistant S. pneumoniae

Additional relevant MeSH terms:
Anti-Bacterial Agents
Antibiotics, Antitubercular
Anti-Infective Agents
Antitubercular Agents
Pharmacologic Actions
Therapeutic Uses processed this record on February 07, 2016