The Impact of an Antimicrobial Utilization Program on Antimicrobial Use

NCT00552838 | Completed DMC

• 1 other identifier: 579-2002 Emory IRB
• Study Type: interventional
• Target: 785
• Locations: 1 country
• Sites: 1

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).

Conditions

Antimicrobial Prescribing Practices

Keywords

Antimicrobial prescribing; Antimicrobial utilization

Outcome Measures

Primary Outcomes (1)

• Proportion of Appropriateness of Antimicrobial Prescriptions in each group.

  10-month period

Secondary Outcomes (1)

• Clinical Cure Rate, Mortality Rate between the two groups

  10-month period

Study Arms (1)

A

NO INTERVENTION

Physicians in this arm did not have any intervention with the AUT. Antimicrobial prescriptions were based on hospital guidelines or on the physician's medical knowledge.

Behavioral: Academic Detailing by the Antimicrobial Utilization Team (AUT)

Interventions

Academic Detailing by the Antimicrobial Utilization Team (AUT) BEHAVIORAL

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.

A

Eligibility Criteria

• Age: 18 Years - 85 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• All patients prescribed vancomycin, piperacillin-tazobactam, or levofloxacin during the time period of the study.

Sponsors & Collaborators

• Washington University School of Medicine: lead
• Emory University: collaborator

Study Sites (1)

Grady Memorial Hospital

Atlanta, Georgia, 30303, United States

Location

Related Publications (1)

• Camins BC, King MD, Wells JB, Googe HL, Patel M, Kourbatova EV, Blumberg HM. Impact of an antimicrobial utilization program on antimicrobial use at a large teaching hospital: a randomized controlled trial. Infect Control Hosp Epidemiol. 2009 Oct;30(10):931-8. doi: 10.1086/605924.

  PMID: 19712032 DERIVED

Study Officials

• Mark D King, MD, MSCR

  Emory University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Intervention Model: PARALLEL
• Sponsor Type: OTHER

Study Record Dates

• First Submitted: October 29, 2007
• First Posted: November 2, 2007
• Study Start: October 1, 2002
• Study Completion: August 1, 2003
• Last Updated: November 2, 2007

Record last verified: 2007-09

Locations

US (1)