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
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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 |
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 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 |

Arm | Intervention/treatment |
---|---|
No Intervention: Usual information policy
No specific intervention
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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 |
- Percentage of prescriptions of penicillin for respiratory tract infections [ Time Frame: Two years ]
- Percentage of prescriptions of TMP/SMX for lower urinary tract infections in adults [ Time Frame: Two years ]
- Percentage of prescriptions of quinolone for COPD exacerbations in adults [ Time Frame: Two years ]
- Percentage of antibiotic prescriptions for the indications "sinusitis" and "other upper respiratory tract infections" [ Time Frame: Two years ]

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Ages Eligible for Study: | Child, Adult, Older Adult |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Patients with respiratory tract infections or urinary tract infections
Exclusion Criteria
- Patients with chronic disease requiring regular antibiotic treatment

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
Switzerland | |
Institute for Infectious Diseases | |
Bern, Switzerland, 3010 |
Principal Investigator: | Andreas Kronenberg, Dr. med. | University of Bern |
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 |
antimicrobial resistance antibiotic prescription primary health care cluster-randomized trial |
Infection Communicable Diseases Urinary Tract Infections Respiratory Tract Infections |
Urologic Diseases Respiratory Tract Diseases Anti-Bacterial Agents Anti-Infective Agents |