Optimizing Antibiotic Use in Long Term Care - Full Text View

Purpose

The purpose of this study was to determine if a multi-faceted intervention to implement diagnostic and therapeutic algorithms for management of suspected urinary infection in nursing home residents could reduce antibiotic prescribing for urinary indications in this population.

Condition	Intervention
Urinary Tract Infection, Antibiotic Use	Behavioral: diagnostic and treatment clinical algorithms

MedlinePlus related topics:

Antibiotics Urinary Tract Infections

U.S. FDA Resources

Study Type:	Interventional
Study Design:	Educational/Counseling/Training, Randomized, Open Label, Active Control, Parallel Assignment, Efficacy Study

Official Title:	Optimizing Antibiotic Use in Long Term Care

Further study details as provided by Agency for Healthcare Research and Quality (AHRQ):

Primary Outcome Measures:

Antimicrobial prescriptions

Secondary Outcome Measures:

Urinary cultures,
hospitalizations, deaths

Study Start Date:	January 2001
Estimated Study Completion Date:	July 2003

Detailed Description:

Antibiotic use is intense in nursing homes and frequently inappropriate when prescribed for urinary indications. Evidence from randomized controlled trials suggests that treatment of asymptomatic bacteriuria, the presence of bacteria in the urine in the absence of urinary symptoms, is not beneficial. Despite this, one in three prescriptions for urinary indications are for asymptomatic bacteriuria. To improve antibiotic prescribing in this setting we conducted a cluster randomized trial of a strategy to implement diagnostic and treatment algorithms for urinary infection. 24 nursing homes were randomized to either the intervention (implemented at the nursing home level using a multi-faceted approach: small group interactive sessions for nurses, one-on-one interviews for physicians, videotapes, written material, and outreach visits) or to usual care.

Eligibility

Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

Individuals- all residents eligible
Nursing homes
- Free standing long term care facilities with >100 beds
- No stated policy for diagnosis or treatment of urinary tract infections
- The facility agrees to refrain from introducing new strategies for antibiotic utilization or clinical pathways during study

Exclusion Criteria:

-

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00243360

Locations


Canada, Ontario
	McMaster University
	Hamilton, Ontario, Canada, L8N 3Z5

Sponsors and Collaborators

Agency for Healthcare Research and Quality (AHRQ)

Investigators


Principal Investigator:	Mark B Loeb, MD MSc FRCPC	Hamilton Health Sciences

More Information

Study ID Numbers:	U18 HS11113-01
First Received:	October 21, 2005
Last Updated:	October 21, 2005
ClinicalTrials.gov Identifier:	NCT00243360
Health Authority:	United States: Federal Government; Canada: Health Canada

Keywords provided by Agency for Healthcare Research and Quality (AHRQ):

Urinary tract infections,

antibiotic use,

long term care facilities

Study placed in the following topic categories:

Urologic Diseases

Urinary Tract Infections

Additional relevant MeSH terms:

Infection

ClinicalTrials.gov processed this record on October 09, 2008

Sponsored by:	Agency for Healthcare Research and Quality (AHRQ)
Information provided by:	Agency for Healthcare Research and Quality (AHRQ)
ClinicalTrials.gov Identifier:	NCT00243360