Acute Sinusitis, Pneumonia, Streptococcal Pharyngitis, Viral Infection
Conditions
Keywords
antimicrobial stewardship program, inappropriate prescribing of antibiotics, physician prescribing, antibiotic prescribing for respiratory tract infections, respiratory tract infections
Brief summary
The purpose of the study is to determine if physician education coupled with audit and feedback of antibiotic prescribing can improve antibiotic prescribing by primary care clinicians.
Detailed description
Using a large, diverse pediatric primary care network sharing a comprehensive electronic health record (EHR), a cluster-randomized trial will be performed to determine the effectiveness of an outpatient antimicrobial stewardship bundle, including treatment guidelines coupled with audit and feedback of physician prescribing, to curb inappropriate antibiotic prescribing for respiratory tract infections. Aim 1: To determine the impact of an outpatient antimicrobial stewardship bundle within a pediatric primary care network on antibiotic prescribing for conditions for which antibiotics are not indicated. Hypothesis: Antimicrobial stewardship will decrease rates of antibiotic prescribing for conditions for which antibiotics are not indicated. Aim 2: To determine the impact of an outpatient antimicrobial stewardship bundle within a pediatric primary care network on broad-spectrum antibiotic prescribing for conditions for which narrow-spectrum antibiotics are indicated. Hypothesis: Antimicrobial stewardship will decrease the rate of broad-spectrum antibiotic prescribing for conditions for which narrow-spectrum antibiotics are indicated.
Interventions
BEHAVIORALAntimicrobial Stewardship Bundle
Guidelines, Education, Audit and Feedback
Sponsors
Children's Hospital of Philadelphia
Study design
Allocation
RANDOMIZED
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
* Primary care pediatric practices within the CHOP Care Network
Exclusion criteria
* Academic primary care pediatric practices within the CHOP Care Network * Providers entering a practice after the start of the intervention * Providers with less than 25 antibiotic prescriptions in the 6 months prior to the start of the intervention
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Reduction in the rate of broad-spectrum antibiotic prescribing for targeted conditions for which narrow-spectrum antibiotic therapy is indicated | from 20 months prior through 13 months post intervention | The primary outcome measure seeks to determine if the incorporation of treatment guidelines coupled with audit and feedback of physician prescribing can reduce the the rate of antibiotic prescribing for targeted conditions for which antibiotic therapy is not indicated. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| The rate of antibiotic prescribing for targeted conditions for which antibiotic therapy is not indicated | from 20 months prior through 13 months post intervention | The secondary outcome measure seeks to determine the rate of broad-spectrum antibiotic prescribing for targeted conditions for which narrow-spectrum antibiotic therapy is indicated. Thus, two classes of diagnoses will be collected: 1) respiratory tract infections for which no antibiotics are indicated, represented by a group codes indicating common infections with presumed viral etiology and 2) bacterial respiratory tract infections for which narrow spectrum antibiotics are indicated |
Countries
United States
Outcome results
None listed