The Impact of an Antimicrobial Utilization Program on Antimicrobial Use

Not Applicable

Completed

• Conditions: Antimicrobial Prescribing Practices
• Interventions: Behavioral: Academic Detailing by the Antimicrobial Utilization Team (AUT)

• Registration Number: NCT00552838
• Lead Sponsor: Washington University School of Medicine

Brief Summary

Multidisciplinary antimicrobial utilization teams (AUT) have been proposed as an effective mechanism for improving antimicrobial use, but data on their efficacy remain limited. The researchers postulated that a multi-disciplinary AUT would improve antimicrobial use in a teaching hospital when compared to the standard of care (no AUT intervention).

Design: Randomized-controlled intervention trial. Setting: A 953-bed urban teaching hospital.

Patients: Patients admitted to internal medicine ward teams who were prescribed selected antimicrobial agents (piperacillin-tazobactam, levofloxacin, or vancomycin) during the 10month study period.

Intervention: Eight internal medicine ward teams were randomized monthly to academic detailing by the AUT while 8 internal medicine ward teams were randomized indication-based prescription of broad spectrum antimicrobials.

Measurements: Proportion of appropriate empiric, definitive, and end antimicrobial usage (antimicrobial use from the initiation of therapy until definitive therapy is prescribed).

Detailed Description

This study was conducted when Bernard C Camins, MD (BCC), one of the investigators, was still employed at Emory University. The principal investigator is no longer at Emory University. This trial is being registered by one of the investigators, BCC, so we can submit the manuscript for publication. BCC is now at Washington University and this study was conducted while he was at Emory University.

Study Timeline

• Study Start: 2002-10
• Study Completion: 2003-08
• Status Verified: 2007-09
• Study First Submitted: 2007-10-29
• Study First Submitted QC: 2007-10-31
• Last Update Submitted: 2007-10-31
• Study First Posted: 2007-11-02
• Last Update Posted: 2007-11-02

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 785

Inclusion Criteria

• All patients prescribed vancomycin, piperacillin-tazobactam, or levofloxacin during the time period of the study.

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Exclusion Criteria

Not provided

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
A	Academic Detailing by the Antimicrobial Utilization Team (AUT)	Physicians in this arm did not have any intervention with the AUT. Antimicrobial prescriptions were based on hospital guidelines or on the physician's medical knowledge.

Primary Outcome Measures

Name	Time	Method
Proportion of Appropriateness of Antimicrobial Prescriptions in each group.	10-month period

Secondary Outcome Measures

Name	Time	Method
Clinical Cure Rate, Mortality Rate between the two groups	10-month period

Trial Locations

Locations (1)

Grady Memorial Hospital; 🇺🇸 Atlanta, Georgia, United States