NCT00129883

Adherence to Guidelines for Antibiotic Use in Respiratory Infections at Hospitals

Prevention of Antimicrobial Resistance in Hospitals: Promoting Appropriate Use of Antibiotics in Hospital Departments of Internal and Pulmonary Medicine

• Status: Completed
• Phase: N/A
• Study type: Interventional
• Enrollment: 2,000 (planned)
• Sponsor: Radboud University Medical Center · Academic / Other
• Sex: All
• Age: 18 Years
• Healthy volunteers: Not accepted

Summary

The purpose of this study is to test a strategy to improve the quality of antibiotic use in lower respiratory tract infections (LRTIs) at hospitals. Therefore, a multifaceted intervention strategy is compared to a control strategy and the effectiveness and feasibility of the intervention is assessed.

Detailed description

Improving processes of care in patients with hospital LRTI has been related to better patient outcome. Inappropriate use of antibiotics has contributed to the emergence and spread of drug-resistant micro organisms and increased treatment costs. International guidelines provide recommendations for the initial evaluation and management of LRTI, including advice on judicious antibiotic therapy. Nonetheless, studies have demonstrated a wide variability in adherence to these guidelines. To implement key recommendations in clinical practice, various strategies have been used, with mixed results. Perhaps the most important aspect of choosing a potentially effective intervention is that the choice of intervention should be based upon assessment of potential barriers in the target group. Many intervention studies are flawed by failing to control for secular trends. The investigators performed a cluster randomised controlled trial, to study the effect of a multifaceted intervention strategy on the quality of antibiotic use for LRTI. Their intervention was tailored to the areas most in need for improvement and took perceived barriers in the target group into consideration at the individual hospital level.

Conditions

• Pneumonia
• Chronic Bronchitis
• COPD

Interventions

Type	Name	Description
BEHAVIORAL	Professional education
BEHAVIORAL	Implementation of a Critical Care Pathway
BEHAVIORAL	Professional audit and feedback
BEHAVIORAL	Process analysis and redesign

Timeline

• Start date: 2002-09-01
• Completion: 2005-04-01
• First posted: 2005-08-12
• Last updated: 2005-09-27

Locations

7 sites across 1 country: Netherlands