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Optimizing Antibiotic Use in Long Term Care

Primary Purpose

Urinary Tract Infection, Antibiotic Use

Status

Completed

Phase

Not Applicable

Locations

Canada

Study Type

Interventional

Intervention

diagnostic and treatment clinical algorithms

About this trial

This is an interventional educational/counseling/training trial for Urinary Tract Infection, Antibiotic Use focused on measuring Urinary tract infections,, antibiotic use,, long term care facilities

Eligibility Criteria

0 Years - undefined (Child, Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Individuals- all residents eligible Nursing homes Free standing long term care facilities with >100 beds No stated policy for diagnosis or treatment of urinary tract infections The facility agrees to refrain from introducing new strategies for antibiotic utilization or clinical pathways during study Exclusion Criteria: -

Sites / Locations

McMaster University

Outcomes

Primary Outcome Measures

Antimicrobial prescriptions

Secondary Outcome Measures

Urinary cultures,

hospitalizations, deaths

Full Information

NCT ID

NCT00243360

First Posted

October 21, 2005

Last Updated

October 21, 2005

Sponsor

Agency for Healthcare Research and Quality (AHRQ)

1. Study Identification

Unique Protocol Identification Number

NCT00243360

Brief Title

Optimizing Antibiotic Use in Long Term Care

Official Title

Optimizing Antibiotic Use in Long Term Care

Study Type

Interventional

2. Study Status

Record Verification Date

October 2005

Overall Recruitment Status

Completed

Study Start Date

January 2001 (undefined)

Primary Completion Date

undefined (undefined)

Study Completion Date

July 2003 (undefined)

3. Sponsor/Collaborators

Name of the Sponsor

Agency for Healthcare Research and Quality (AHRQ)

4. Oversight

5. Study Description

Brief Summary

The purpose of this study was to determine if a multi-faceted intervention to implement diagnostic and therapeutic algorithms for management of suspected urinary infection in nursing home residents could reduce antibiotic prescribing for urinary indications in this population.

Detailed Description

Antibiotic use is intense in nursing homes and frequently inappropriate when prescribed for urinary indications. Evidence from randomized controlled trials suggests that treatment of asymptomatic bacteriuria, the presence of bacteria in the urine in the absence of urinary symptoms, is not beneficial. Despite this, one in three prescriptions for urinary indications are for asymptomatic bacteriuria. To improve antibiotic prescribing in this setting we conducted a cluster randomized trial of a strategy to implement diagnostic and treatment algorithms for urinary infection. 24 nursing homes were randomized to either the intervention (implemented at the nursing home level using a multi-faceted approach: small group interactive sessions for nurses, one-on-one interviews for physicians, videotapes, written material, and outreach visits) or to usual care.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study

Urinary Tract Infection, Antibiotic Use

Keywords

Urinary tract infections,, antibiotic use,, long term care facilities

7. Study Design

Primary Purpose

Educational/Counseling/Training

Study Phase

Not Applicable

Interventional Study Model

Parallel Assignment

Masking

None (Open Label)

Allocation

Randomized

8. Arms, Groups, and Interventions

Intervention Type

Behavioral

Intervention Name(s)

diagnostic and treatment clinical algorithms

Primary Outcome Measure Information:

Title

Antimicrobial prescriptions

Secondary Outcome Measure Information:

Title

Urinary cultures,

Title

hospitalizations, deaths

10. Eligibility

Sex

All

Minimum Age & Unit of Time

0 Years

Accepts Healthy Volunteers

Eligibility Criteria

Overall Study Officials:

First Name & Middle Initial & Last Name & Degree

Mark B Loeb, MD MSc FRCPC

Organizational Affiliation

McMaster University

Official's Role

Principal Investigator

Facility Information:

Facility Name

McMaster University

City

Hamilton

State/Province

Ontario

ZIP/Postal Code

L8N 3Z5

Country

Canada

12. IPD Sharing Statement

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Optimizing Antibiotic Use in Long Term Care

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