Optimizing Antibiotic Use in Long Term Care

Urinary Tract Infection, Antibiotic Use Clinical Trial

Official title:

Optimizing Antibiotic Use in Long Term Care

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT00243360
• Other study ID #: U18HS011113-01
• Status: Completed
• Phase: N/A
• First received: October 21, 2005
• Last updated: October 21, 2005
• Start date: January 2001
• Est. completion date: July 2003

Study information

• Verified date: October 2005
• Source: Agency for Healthcare Research and Quality (AHRQ)
• Contact: n/a
• Is FDA regulated: No
• Health authority: United States: Federal GovernmentCanada: Health Canada
• Study type: Interventional

Clinical Trial Summary

The purpose of this study was to determine if a multi-faceted intervention to implement diagnostic and therapeutic algorithms for management of suspected urinary infection in nursing home residents could reduce antibiotic prescribing for urinary indications in this population.

Description:

Antibiotic use is intense in nursing homes and frequently inappropriate when prescribed for urinary indications. Evidence from randomized controlled trials suggests that treatment of asymptomatic bacteriuria, the presence of bacteria in the urine in the absence of urinary symptoms, is not beneficial. Despite this, one in three prescriptions for urinary indications are for asymptomatic bacteriuria. To improve antibiotic prescribing in this setting we conducted a cluster randomized trial of a strategy to implement diagnostic and treatment algorithms for urinary infection. 24 nursing homes were randomized to either the intervention (implemented at the nursing home level using a multi-faceted approach: small group interactive sessions for nurses, one-on-one interviews for physicians, videotapes, written material, and outreach visits) or to usual care.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 0
• Est. completion date: July 2003
• Accepts healthy volunteers: No
• Gender: Both
• Age group: N/A and older

Eligibility

Inclusion Criteria:

1. Individuals- all residents eligible

2. Nursing homes

• Free standing long term care facilities with >100 beds

• No stated policy for diagnosis or treatment of urinary tract infections

• The facility agrees to refrain from introducing new strategies for antibiotic utilization or clinical pathways during study

Exclusion Criteria:

Study Design

Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Educational/Counseling/Training

Related Conditions & MeSH terms

• Urinary Tract Infection, Antibiotic Use
• Urinary Tract Infections

Intervention

Behavioral:
• diagnostic and treatment clinical algorithms

Locations

Country	Name	City	State
Canada	McMaster University	Hamilton	Ontario

Sponsors (1)

Lead Sponsor	Collaborator
Agency for Healthcare Research and Quality (AHRQ)

Country where clinical trial is conducted

Canada, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Antimicrobial prescriptions
Secondary	Urinary cultures,
Secondary	hospitalizations, deaths