Antimicrobial Stewardship for Primary Care Pediatricians

Not Applicable

Completed

• Conditions: Acute Sinusitis; Streptococcal Pharyngitis; Pneumonia; Viral Infection
• Interventions: Behavioral: Antimicrobial Stewardship Bundle

• Registration Number: NCT01806103
• Lead Sponsor: Children's Hospital of Philadelphia

Brief Summary

The purpose of the study is to determine if physician education coupled with audit and feedback of antibiotic prescribing can improve antibiotic prescribing by primary care clinicians.

Detailed Description

Using a large, diverse pediatric primary care network sharing a comprehensive electronic health record (EHR), a cluster-randomized trial will be performed to determine the effectiveness of an outpatient antimicrobial stewardship bundle, including treatment guidelines coupled with audit and feedback of physician prescribing, to curb inappropriate antibiotic prescribing for respiratory tract infections.

Aim 1: To determine the impact of an outpatient antimicrobial stewardship bundle within a pediatric primary care network on antibiotic prescribing for conditions for which antibiotics are not indicated.

Hypothesis: Antimicrobial stewardship will decrease rates of antibiotic prescribing for conditions for which antibiotics are not indicated.

Aim 2: To determine the impact of an outpatient antimicrobial stewardship bundle within a pediatric primary care network on broad-spectrum antibiotic prescribing for conditions for which narrow-spectrum antibiotics are indicated.

Hypothesis: Antimicrobial stewardship will decrease the rate of broad-spectrum antibiotic prescribing for conditions for which narrow-spectrum antibiotics are indicated.

Study Timeline

• Study Start: 2010-06
• Primary Completion: 2011-06
• Study Completion: 2012-12
• Study First Submitted: 2013-02-04
• Status Verified: 2013-03
• Study First Submitted QC: 2013-03-05
• Last Update Submitted: 2013-03-05
• Study First Posted: 2013-03-07
• Last Update Posted: 2013-03-07

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 170

Inclusion Criteria

• Primary care pediatric practices within the CHOP Care Network

Exclusion Criteria

• Academic primary care pediatric practices within the CHOP Care Network
• Providers entering a practice after the start of the intervention
• Providers with less than 25 antibiotic prescriptions in the 6 months prior to the start of the intervention

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
Antimicrobial Stewardship Bundle	Antimicrobial Stewardship Bundle	An intervention "bundle" to reduce outpatient antibiotic use in children will include education, creation of and access to guidelines, and audit of and feedback on individual prescribing within the context of achievable benchmarks.

Primary Outcome Measures

Name	Time	Method
Reduction in the rate of broad-spectrum antibiotic prescribing for targeted conditions for which narrow-spectrum antibiotic therapy is indicated	from 20 months prior through 13 months post intervention	The primary outcome measure seeks to determine if the incorporation of treatment guidelines coupled with audit and feedback of physician prescribing can reduce the the rate of antibiotic prescribing for targeted conditions for which antibiotic therapy is not indicated.

Secondary Outcome Measures

Name	Time	Method
The rate of antibiotic prescribing for targeted conditions for which antibiotic therapy is not indicated	from 20 months prior through 13 months post intervention	The secondary outcome measure seeks to determine the rate of broad-spectrum antibiotic prescribing for targeted conditions for which narrow-spectrum antibiotic therapy is indicated. Thus, two classes of diagnoses will be collected: 1) respiratory tract infections for which no antibiotics are indicated, represented by a group codes indicating common infections with presumed viral etiology and 2) bacterial respiratory tract infections for which narrow spectrum antibiotics are indicated

Trial Locations

Locations (1)

The Children's Hospital of Philadelphia; 🇺🇸 Philadelphia, Pennsylvania, United States