NCT03379194

Routine Antibiotic Prescription Monitoring in Primary Care Physicians: A Nationwide Trial

Completed NA Last updated 18 November 2022

What this trial tests

NA trial testing Antibiotic stewardship program in Acute Respiratory Tract Infection in 3,426 participants. Completed in 31 December 2019.

Timeline

2 January 2018

Primary endpoint
31 December 2019

31 December 2019

Quick facts

Lead sponsor	University Hospital, Basel, Switzerland
Phase	NA
Status	Completed
Study type	INTERVENTIONAL
Allocation	randomized
Design	parallel
Masking	triple
Primary purpose	health services research
Enrollment	3,426
Start date	2 January 2018
Primary completion	31 December 2019
Estimated completion	31 December 2019
Sites	1 location across Switzerland

Drugs / interventions tested

• Antibiotic stewardship program

Conditions studied

• Acute Respiratory Tract Infection — all drugs for Acute Respiratory Tract Infection →
• Urinary Tract Infections — all drugs for Urinary Tract Infections →

Sponsor

University Hospital, Basel, Switzerland

Who can join

Eligibility, any sex, with Acute Respiratory Tract Infection or Urinary Tract Infections. Patients with the condition only — healthy volunteers not accepted.

Sponsor's own description

Antibiotic resistance is an increasingly serious problem in Switzerland which is associated with the exposure and overall uptake of antibiotics in a population. Reduced antibiotic prescribing for outpatients is paralleled by a decrease in antibiotic resistance rates.

In a recent pragmatic trial, the investigators found only promising yet not very conclusive results as those were present only in some groups. This nationwide antibiotic stewardship program with routine feedback on antibiotic prescribing was not associated with an overall change in antibiotic use. In older children, adolescents, and younger adults fewer antibiotics were prescribed, but not consistently over the entire intervention period.

Hence, the investigators now aim to evaluate a better-tailored program to obtain a better understanding of the effects on patient-relevant outcomes, antibiotic resistance, and the underlying mechanisms leading to different effects in certain subgroups of patients.

The investigators plan to evaluate a nationwide antibiotic stewardship program combining routine prescription feedback with the provision of physician and patient education material for primary care physicians in Switzerland. The project is conducted within the framework of the National Program on antimicrobial resistance by the Swiss National Science Foundation. Also, additional subprojects will be done where we will assess the impact of COVID-19 on AB prescription by comparing the years 2017,2018, and 2019 with the year 2020 data.

Publications & conference data

3 peer-reviewed publications reference this trial (live from Europe PMC):

1. Advances in optimizing the prescription of antibiotics in outpatient settings.
   King LM, Fleming-Dutra KE, Hicks LA. · · 2018 · cited 94× · PMID 30420401 · DOI 10.1136/bmj.k3047
2. Effect of Antibiotic Prescription Audit and Feedback on Antibiotic Prescribing in Primary Care: A Randomized Clinical Trial.
   Aghlmandi S, Halbeisen FS, Saccilotto R, Godet P, et al · · 2023 · cited 25× · PMID 36745412 · DOI 10.1001/jamainternmed.2022.6529
3. Impact of the COVID-19 Pandemic on Antibiotic Prescribing in High-Prescribing Primary Care Physicians in Switzerland
   Aghlmandi S, Halbeisen FS, Godet P, Signorell A, et al · · 2023 · DOI 10.2139/ssrn.4521523