Can Change in Physicians' Prescribing Habits Decrease Carriage of Resistant Bacteria in the Community?
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 5,700
- 主要终点
- antibiotic prescription rate of physicians
研究概览
简要总结
This study aims to implement judicious antibiotic prescription habits to primary care pediatricians using a multifacet educational intervention and assess two main outcomes: 1) Direct outcome - prescription rates of the physicians. 2)Indirect outcome - carriage of antibiotic resistant bacteria by the treated population, specifically nasopharyngeal S. pneumoniae, nasal S. aureus and rectal E.coli.
详细描述
Background: Bacterial antibiotic resistance is an increasing problem.
Aims: This study aims to implement judicious antibiotic prescription habits among 30 physicians and their treated population as compared to a control group of 30 physicians and their treated population. The outcomes to be measured are:
- Change in antibiotic prescriptions to the treated patients of the intervention vs. control physicians during the study period (4years).
- Change in carriage of antibiotic resistant pathogens, specifically nasopharyngeal penicillin resistant S. pneumoniae,nasal MRSA, and rectal quinolone resistant E. coli.
Study design: All primary care pediatricians of Hashfela district of Macabbi Healthcare services who will agree to participate will be randomly assigned to an intervention or control group. The intervention group will be led by local leaders (primary care physicians from that district) and will take part in educational activities involving annual workshops and quarterly focus group meetings. The intervention is a multifacet intervention that will include guideline preparation, knowledge building, dealing with uncertainties, etc.
The patients of both intervention and control physicians will be screened twice a year for carriage of the bacteria mentioned above. Cross-sectional screening of the treated population will be carried in Summer and winter for 5 consecutive years. Screening will include signing an informed consent, filling a questionnaire and screening with nasal, nasopharyngeal and rectal swabs.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Prevention
- 盲法
- None
入排标准
- 年龄范围
- — 至 5 Years（Child）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •All treated patients of the participating physicians under the age of 5y, who came for any reason for a visit during the study period, who's parents agreed to participate.
排除标准
- •The only reason to exclude a child from being recruited was age>5y or refusal of the parent/child to participate.
结局指标
主要结局
antibiotic prescription rate of physicians
时间窗: 5 years
Antibiotic prescrption rate at baseline will be compared to changes following the intervention between the 2 groups (control and intervention).
次要结局
- Carriage of antibiotic resistant bacteria by treated patients(4 years)