Antimicrobial Prescribing Practices
Conditions
Keywords
Antimicrobial prescribing, Antimicrobial utilization
Brief summary
Multidisciplinary antimicrobial utilization teams (AUT) have been proposed as an effective mechanism for improving antimicrobial use, but data on their efficacy remain limited. The researchers postulated that a multi-disciplinary AUT would improve antimicrobial use in a teaching hospital when compared to the standard of care (no AUT intervention). Design: Randomized-controlled intervention trial. Setting: A 953-bed urban teaching hospital. Patients: Patients admitted to internal medicine ward teams who were prescribed selected antimicrobial agents (piperacillin-tazobactam, levofloxacin, or vancomycin) during the 10month study period. Intervention: Eight internal medicine ward teams were randomized monthly to academic detailing by the AUT while 8 internal medicine ward teams were randomized indication-based prescription of broad spectrum antimicrobials. Measurements: Proportion of appropriate empiric, definitive, and end antimicrobial usage (antimicrobial use from the initiation of therapy until definitive therapy is prescribed).
Detailed description
This study was conducted when Bernard C Camins, MD (BCC), one of the investigators, was still employed at Emory University. The principal investigator is no longer at Emory University. This trial is being registered by one of the investigators, BCC, so we can submit the manuscript for publication. BCC is now at Washington University and this study was conducted while he was at Emory University.
Interventions
BEHAVIORALAcademic Detailing by the Antimicrobial Utilization Team (AUT)
Physicians caring for patients who were prescribed one of three antimicrobials were randomly assigned to academic detailing by the AUT. The AUT would review the antimicrobial prescription and provide consultation to the ordering physician if the prescription is appropriate and provide feedback on a better alternative if inappropriate.
Sponsors
Emory University
Washington University School of Medicine
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 85 Years
Healthy volunteers
No
Inclusion criteria
* All patients prescribed vancomycin, piperacillin-tazobactam, or levofloxacin during the time period of the study.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Proportion of Appropriateness of Antimicrobial Prescriptions in each group. | 10-month period |
Secondary
| Measure | Time frame |
|---|---|
| Clinical Cure Rate, Mortality Rate between the two groups | 10-month period |
Countries
United States
Outcome results
None listed