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Intervention Study to Improve Antibiotic Prescription in Outpatient Care (SAPI)

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ClinicalTrials.gov Identifier: NCT01358916
Recruitment Status : Completed
First Posted : May 24, 2011
Last Update Posted : March 29, 2013
Sponsor:
Collaborators:
Bundesamt für Gesundheit
Sentinella Netzwerk
Schweizerische Gesellschaft für Infektiologie
Pädiatrische Infektiologie Gruppe Schweiz
Information provided by (Responsible Party):
University of Bern

Study Description
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Brief Summary:

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.


Condition or disease Intervention/treatment Phase
Respiratory Tract Infections Urinary Tract Infections Other: Mailing of antibiotic therapy guidelines to the sentinel physicians Not Applicable

Detailed Description:

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.

Study Design
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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 140 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Official Title: Improvement of Antibiotic Prescription in Outpatient Care: a Cluster-randomised Intervention Study Using a Sentinel Surveillance Network of Physicians
Study Start Date : November 2010
Actual Primary Completion Date : December 2012
Actual Study Completion Date : December 2012

Resource links provided by the National Library of Medicine


Arms and Interventions
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Arm Intervention/treatment
No Intervention: Usual information policy
No specific intervention
Antibiotic therapy guidelines Other: Mailing of antibiotic therapy guidelines to the sentinel physicians
Mailing of antibiotic therapy guidelines to the sentinel physicians and regular feedback on antibiotic prescription


Outcome Measures
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Primary Outcome Measures :
  1. Percentage of prescriptions of penicillin for respiratory tract infections [ Time Frame: Two years ]
  2. Percentage of prescriptions of TMP/SMX for lower urinary tract infections in adults [ Time Frame: Two years ]

Secondary Outcome Measures :
  1. Percentage of prescriptions of quinolone for COPD exacerbations in adults [ Time Frame: Two years ]
  2. Percentage of antibiotic prescriptions for the indications "sinusitis" and "other upper respiratory tract infections" [ Time Frame: Two years ]

Eligibility Criteria
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Ages Eligible for Study:   Child, Adult, Older Adult
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Patients with respiratory tract infections or urinary tract infections

Exclusion Criteria

  • Patients with chronic disease requiring regular antibiotic treatment
Contacts and Locations
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Information from the National Library of Medicine

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): NCT01358916


Locations
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Switzerland
Institute for Infectious Diseases
Bern, Switzerland, 3010
Sponsors and Collaborators
University of Bern
Bundesamt für Gesundheit
Sentinella Netzwerk
Schweizerische Gesellschaft für Infektiologie
Pädiatrische Infektiologie Gruppe Schweiz
Investigators
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Principal Investigator: Andreas Kronenberg, Dr. med. University of Bern
More Information
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Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):

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Responsible Party: University of Bern
ClinicalTrials.gov Identifier: NCT01358916    
Other Study ID Numbers: Swiss Federal Office of Health
First Posted: May 24, 2011    Key Record Dates
Last Update Posted: March 29, 2013
Last Verified: March 2013
Keywords provided by University of Bern:
antimicrobial resistance
antibiotic prescription
primary health care
cluster-randomized trial
Additional relevant MeSH terms:
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Infection
Communicable Diseases
Urinary Tract Infections
Respiratory Tract Infections
 Urologic Diseases
Respiratory Tract Diseases
Anti-Bacterial Agents
Anti-Infective Agents