The Impact of an Antimicrobial Utilization Program on Antimicrobial Use

This study has been completed.

Sponsor:

Collaborator:

Emory University

Information provided by:

Washington University School of Medicine

ClinicalTrials.gov Identifier:

NCT00552838

First received: October 29, 2007

Last updated: October 31, 2007

Last verified: September 2007

History of Changes

Purpose

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).

Condition	Intervention
Antimicrobial Prescribing Practices	Behavioral: Academic Detailing by the Antimicrobial Utilization Team (AUT)

Study Type:	Interventional
Study Design:	Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Single Blind (Outcomes Assessor)
Official Title:	The Impact of an Antimicrobial Utilization Program on Antimicrobial Use in a Large Public Hospital: A Randomized Controlled Trial

Further study details as provided by Washington University School of Medicine:

Primary Outcome Measures:

Proportion of Appropriateness of Antimicrobial Prescriptions in each group. [ Time Frame: 10-month period ]

Secondary Outcome Measures:

Clinical Cure Rate, Mortality Rate between the two groups [ Time Frame: 10-month period ]

Enrollment:	785
Study Start Date:	October 2002
Study Completion Date:	August 2003

Arms	Assigned Interventions
No Intervention: A 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) 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.

Arms

Assigned Interventions

No Intervention: A

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)

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.

Detailed Description:

This study was conducted when Bernard C Camins, MD (BCC), one of the investigators, was still employed at Emory University. The principal investigator is no longer at Emory University. This trial is being registered by one of the investigators, BCC, so we can submit the manuscript for publication. BCC is now at Washington University and this study was conducted while he was at Emory University.

Eligibility

Ages Eligible for Study:	18 Years to 85 Years
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

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

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00552838

Locations

United States, Georgia
Grady Memorial Hospital
Atlanta, Georgia, United States, 30303

Sponsors and Collaborators

Washington University School of Medicine

Emory University

Investigators

Principal Investigator:

Mark D King, MD, MSCR

Emory University

More Information

No publications provided by Washington University School of Medicine

Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):

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.

ClinicalTrials.gov Identifier:	NCT00552838 History of Changes
Other Study ID Numbers:	579-2002 Emory IRB
Study First Received:	October 29, 2007
Last Updated:	October 31, 2007
Health Authority:	United States: Institutional Review Board

Keywords provided by Washington University School of Medicine:

Antimicrobial prescribing
Antimicrobial utilization

Additional relevant MeSH terms:

Anti-Infective Agents
Therapeutic Uses
Pharmacologic Actions

ClinicalTrials.gov processed this record on May 22, 2013

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