Urinary Tract Infections Clinical Trial
Official title:
Improvement of Antibiotic Prescription in Outpatient Care: a Cluster-randomised Intervention Study Using a Sentinel Surveillance Network of Physicians
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.
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.
;
Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Open Label
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