Decreasing Antibiotic Duration for Skin and Soft Tissue Infection Using Behavioral Economics in Primary Care

NCT05226260 | Completed

• 1 other identifier: STUDY00001964
• Study Type: interventional
• Target: 1,634
• Locations: 1 country
• Sites: 1

Brief Summary

Study the efficacy of a package of behavioral economics strategies (versus an education-only control condition) in altering clinician behavior regarding antibiotic prescription duration for skin and soft tissue infection (SSTI).

Conditions

Cellulitis; Abscess; Drain Abscess; Impetigo; Skin Infection; Antibiotic Duration; Behavioral Economics

Outcome Measures

Primary Outcomes (1)

• Rate of short antibiotics

  Rates of long and short antibiotics will be analyzed on the clinic and provider level for both intervention and control groups

  12 months

Study Arms (2)

Intervention

EXPERIMENTAL

Intervention clinics receiving fully functional Epic order panel with set default \[short\] duration by diagnosis: for cellulitis and drained abscess, 5 days. For impetigo and undrained abscess, 7 days.

Behavioral: Default Duration order Panel

Control

NO INTERVENTION

Control clinics receiving basic Epic order panel with antibiotic doses by diagnosis but duration free text (must be entered manually by clinician prescriber).

Interventions

Default Duration order Panel BEHAVIORAL

The SSTI order panel will present itself when a provider types in either a drug name or diagnosis (cellulitis, impetigo, etc). Clinicians in control clinics will have access to a basic order panel which will include diagnosis and corresponding antibiotic of choice. Clinicians in intervention clinics will have access to order panels with the following additional components: prepopulated order duration fields that default to the recommended treatment duration.

Intervention

Eligibility Criteria

• Age: 3 Months - 99 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• diagnosis codes A46 (cellulitis), L03 (cellulitis and acute lymphangitis), J34 or L02 (abscess, furuncle), or L01 (impetigo) AND
• those who received a prescription for an enteral antibiotic
• patient's treated in Nationwide Children's Hospital primary care clinics

You may not qualify if:

• Patients less than 3 months of age
• Animal bite
• Human bite
• Foreign body
• Diagnosis of hidradenitis suppurativa
• Immunocompromising conditions (primary immune deficiency, chemotherapy, etc)
• burns

Sponsors & Collaborators

• Nationwide Children's Hospital: lead

Study Sites (1)

Nationwide Children's Hospital Primary Care Clinics

Columbus, Ohio, 43205, United States

Location

Related Publications (1)

• Broussard KA, Chaparro JD, Erdem G, Abdel-Rasoul M, Stevens J, Watson JR. Default Antibiotic Order Durations for Skin and Soft Tissue Infections in Outpatient Pediatrics: A Cluster Randomized Trial. J Pediatric Infect Dis Soc. 2025 Jan 20;14(1):piae127. doi: 10.1093/jpids/piae127.

  PMID: 39665614 RESULT

MeSH Terms

Conditions

Cellulitis; Abscess; Impetigo

Condition Hierarchy (Ancestors)

Skin Diseases, Infectious; Infections; Suppuration; Connective Tissue Diseases; Skin and Connective Tissue Diseases; Inflammation; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Staphylococcal Skin Infections; Staphylococcal Infections; Gram-Positive Bacterial Infections; Bacterial Infections; Bacterial Infections and Mycoses; Streptococcal Infections; Skin Diseases, Bacterial; Skin Diseases

Study Officials

• Kali Broussard, MD

  Nationwide Children's Hospital

  PRINCIPAL INVESTIGATOR

• Joshua Watson, MD

  Nationwide Children's Hospital

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: TRIPLE
• Who Masked: PARTICIPANT, CARE PROVIDER, INVESTIGATOR
• Purpose: OTHER
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: November 3, 2021
• First Posted: February 7, 2022
• Study Start: November 1, 2021
• Primary Completion: January 20, 2025
• Study Completion: January 20, 2025
• Last Updated: April 8, 2025

Record last verified: 2025-04

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)