Development of Customized Antimicrobial Stewardship Program for Rural Hospitals using Hub and Spoke model in districts of West Bengal -a health system implementation research.
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 入组人数
- 3,132
- 试验地点
- 1
- 主要终点
- 3.Parenteral antibiotics prescribing rate (PAPR) - number of prescriptions that included at one injectable antibiotic /total number of prescriptions that included at least one antibiotic × 100.
研究概览
简要总结
Rationale:
Primary care health facilities do not have microbiological diagnostic services and neither any antimicrobial stewardship programs (AMSP) yet a huge proportion of rural population takes empirical antibiotic from these settings.
Novelty: Novelty lies in its approach to establish customized AMSP in Rural Hospitals by linking it to District Medical Colleges through Hub and Spoke Model.
Objectives:
Primary objectives:
-
To generate the baseline data in terms of key AMSP indicators in selected rural hospitals (RH) of two districts of West Bengal
-
To develop and implement customized AMSP intervention in selected RH through the Hub and Spoke Model
-
To evaluate the effectiveness of customized AMSP intervention in RH against control Arm (existing system in RH)
Secondary objective:
1 To identify barriers & facilitators of customized AMSP intervention through Hub and Spoke Model.
Methods: In this Health System Implementation Research through two arm cluster randomized intervention, 6 Rural Hospitals will be selected from 2 districts each (Total 12 RH). 3 RH in each districts will be termed as intervention arm and linked to Medical Colleges and remaining will be control arm.(Standard Practice). Package of AMSP Intervention will include formulation of committee, periodic training of Physician, Nurses, culture and antibiogram, use of point of care test etc. Prescriptions will be evaluated pre and post intervention (1 year) for its effectiveness in terms rational antibiotic prescription indicators.
Expected outcome:
- Determining the effectiveness of customized AMSP interventions through Hub and Spoke model for rationalizing antibiotic usage in primary care settings.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 盲法
- None
入排标准
- 年龄范围
- 1.00 Day(s) 至 90.00 Year(s)（—）
- 性别
- All
入选标准
- •Diseases as follows: Acute Undifferentiated Febrile illness, Urinary Tract Infection, Acute Respiratory Infections, Acute Diarrhoeal Disaeses.
排除标准
- •Unable or Unwilling to provide consent.
结局指标
主要结局
3.Parenteral antibiotics prescribing rate (PAPR) - number of prescriptions that included at one injectable antibiotic /total number of prescriptions that included at least one antibiotic × 100.
时间窗: Pre and Post intervention
(European Surveillance of Antibiotic Consumption)
时间窗: Pre and Post intervention
4.Antibiotic prescribed as per WHO AWaRe classification - Access to Watch Ratio
时间窗: Pre and Post intervention
Indicators:
时间窗: Pre and Post intervention
. 1.Antibiotic prescribing rate (APR) - number of prescriptions that included at least one antibiotic/total number of prescriptions × 100
时间窗: Pre and Post intervention
2. Multiple antibiotics prescribing rate (MPR ) - number of prescriptions that included at least two antibiotics /total number of prescriptions that included at least one antibiotic × 100.
时间窗: Pre and Post intervention
次要结局
- The difference in DDD per 1000 inpatient days (ATC-DDD)(Pre and Post intervention)
研究者
Dr Debjit Chakraborty
ICMR - National Institute for Research in Bacterial Infections