Preventing antimicrobial resistance by promoting appropriate prescription of antibiotics, for acute respiratory infections and diarrhoea among adolescents and adults, at rural health centers in Punjab, Pakistan

A cluster randomized controlled trial to promote appropriate antibiotic prescriptions at rural health centers in Punjab, Pakistan

Status

Recruiting

Phases

Unknown

Study type

Interventional

Source

ISRCTN

Registry ID

ISRCTN32235505

Enrollment

600

Registered

2024-09-09

Start date

2025-07-01

Completion date

Unknown

Last updated

2026-03-23

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Diarrhea and upper respiratory tract infections Infections and Infestations

Interventions

In the control arm the treatment of acute upper respiratory tract infection and diarrhoea will be continued as per routine. However, to ensure comparability, both in intervention and control arms, th

Eligibility

Sex/Gender

All

Age

12 Years to 100 Years

Inclusion criteria

Inclusion criteria: Cluster level: 1. The top 10 rural health centers per district with the best annual OPD attendance will be included in this study Patient level: 1. 12 or more years of age 2. Upper respiratory tract infections and/or acute diarrhea based on clinical case definitions 3. Voluntarily accepts the study’s informed consent and age-appropriate parental consent form

Exclusion criteria

Exclusion criteria: 1. Chronic diarrheal disease 2. Diagnosed as any other lung condition except URTI 3. Severe conditions requiring (inpatient) hospital attention 4. Failure to provide consent

Design outcomes

Primary

Measure	Time frame
The effectiveness of the intervention measured by calculating the proportion of upper respiratory tract infection (URTI)/diarrhea patients getting inappropriate antibiotic prescriptions in the intervention and control arms. This will be a binary outcome variable stating whether the antibiotic prescription is appropriate or inappropriate. This outcome measure will actually be presented as a proportion and percentage change in the appropriate antibiotic prescription among intervention and control arms. The outcome will be assessed exactly 1 year after the intervention, which is known as endline assessment.	—

Measure

Time frame

The effectiveness of the intervention measured by calculating the proportion of upper respiratory tract infection (URTI)/diarrhea patients getting inappropriate antibiotic prescriptions in the intervention and control arms. This will be a binary outcome variable stating whether the antibiotic prescription is appropriate or inappropriate. This outcome measure will actually be presented as a proportion and percentage change in the appropriate antibiotic prescription among intervention and control arms. The outcome will be assessed exactly 1 year after the intervention, which is known as endline assessment.

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Secondary

Measure	Time frame
The subgroups of diarrhea and URTI patients getting inappropriate antibiotic prescription in the intervention and control arms. Upon collecting all the data, the researchers will stratify the dataset into two subgroups: patients diagnosed with upper respiratory tract infections and/or those diagnosed with diarrhea. The effectiveness of the intervention will be evaluated within both subgroups. The assessment is planned for the first quarter of 2026 (January to March).	—

Measure

Time frame

The subgroups of diarrhea and URTI patients getting inappropriate antibiotic prescription in the intervention and control arms. Upon collecting all the data, the researchers will stratify the dataset into two subgroups: patients diagnosed with upper respiratory tract infections and/or those diagnosed with diarrhea. The effectiveness of the intervention will be evaluated within both subgroups. The assessment is planned for the first quarter of 2026 (January to March).

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Countries

Pakistan

Contacts

Public ContactMuhammad Amir Khan

ccp@asd.com.pk+92 (0)51 2611230 3

Outcome results

None listed

Source: ISRCTN (via WHO ICTRP) · Data processed: Apr 3, 2026