Reducing Inappropriate Prescribing of Antibiotics by Primary Care Clinicians
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Enrollment
- 170
- Locations
- 1
- Primary Endpoint
- Reduction in the rate of broad-spectrum antibiotic prescribing for targeted conditions for which narrow-spectrum antibiotic therapy is indicated
Study Overview
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 Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Single Group
- Primary Purpose
- Treatment
- Masking
- None
Eligibility Criteria
- Sex
- All
- Accepts Healthy Volunteers
- No
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
Arms & Interventions
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.
Intervention: Antimicrobial Stewardship Bundle (Behavioral)
Control
Control sites will be within strata to maintain balance of treatment arm within strata
Outcomes
Primary Outcomes
Reduction in the rate of broad-spectrum antibiotic prescribing for targeted conditions for which narrow-spectrum antibiotic therapy is indicated
Time Frame: 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 Outcomes
- The rate of antibiotic prescribing for targeted conditions for which antibiotic therapy is not indicated(from 20 months prior through 13 months post intervention)