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General Practitioner Reassessment of Urinary Infection Antibiotherapy Prescribed by Emergency Departments (ATB-IU)

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ClinicalTrials.gov Identifier: NCT03928951
Recruitment Status : Recruiting
First Posted : April 26, 2019
Last Update Posted : July 10, 2019
Sponsor:
Information provided by (Responsible Party):
Centre Hospitalier Intercommunal de Toulon La Seyne sur Mer

Brief Summary:
Urinary infections are at the origin of many emergency department consultations and antibiotic prescriptions. Increase of bacteria resistance to antibiotics is promoted by an inappropriate use of those antibiotics but initial prescription in emergency departments is complicated by brief clinical examinations, unavailable sampling results and risks of multi-resistant bacteria. Large diffusion of new recommendations for urinary infection management should improve the quality of initial antibiotic prescription. However emergency physicians have no knowledge of the reassessment of antibiotherapy 48 to 72 hours after initial prescription by general practitioners which is a quality criterion of good antibiotic use. The main purpose of this study is to estimate the reassessment rate by general practitioners of the urinary infection antibiotherapies prescribed in emergency departments. This will allow assessing the quality of initial antibiotic prescription and help to improve practices.

Condition or disease Intervention/treatment
Urinary Tract Infections Other: General practitioner reassessment of urinary infection antibiotherapy prescribed by emergency departments

Detailed Description:

Urinary infections are at the origin of many emergency department consultations and antibiotic prescriptions. Increase of bacteria resistance to antibiotics is promoted by an inappropriate use of those antibiotics but initial prescription in emergency departments is complicated by brief clinical examinations, unavailable sampling results and risks of multi-resistant bacteria. Large diffusion of new recommendations for urinary infection management should improve the quality of initial antibiotic prescription. However emergency physicians have no knowledge of the reassessment of antibiotherapy 48 to 72 hours after initial prescription by general practitioners which is a quality criterion of good antibiotic use. The main purpose of this study is to estimate the reassessment rate by general practitioners of the urinary infection antibiotherapies prescribed in emergency departments.

Patients will be informed during their consultation in one of Toulon - La Seyne sur Mer hospital emergency departments. If they don't express opposition to their data collection, they will be included. A form will then be completed by emergency physicians with initial prescribed antibiotherapy, patients' general practitioners contact information and if patients have a shared medical file or not. 4 to 5 days later, patients' general practitioners will be contacted to know if urinary analysis results were transferred from emergency department to practitioners, if antibiotherapy was modified and if patients' shared medical file was consulted.


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Study Type : Observational
Estimated Enrollment : 50 participants
Observational Model: Cohort
Time Perspective: Prospective
Official Title: General Practitioner Reassessment of the Antibiotherapy of Urinary Infections Initially Treated in Emergency Departments
Actual Study Start Date : June 14, 2019
Estimated Primary Completion Date : October 2019
Estimated Study Completion Date : October 2019

Resource links provided by the National Library of Medicine


Group/Cohort Intervention/treatment
Patients suffering from urinary infection
Patients consulting in one of Toulon - La Seyne sur Mer hospital emergency departments because of urinary infection
Other: General practitioner reassessment of urinary infection antibiotherapy prescribed by emergency departments
Antibiotherapy will be prescribed by emergency physicians and general practitioners will be contacted 4 to 5 days later to know if antibiotherapy was modified




Primary Outcome Measures :
  1. Rate of antibiotherapies modified by general practitioners [ Time Frame: 6 months ]
    Number of antibiotic prescriptions modified by general practitioners divided by the total number of initial antibiotic prescriptions


Secondary Outcome Measures :
  1. Rate of initial antibiotherapies not relevant to recommendations [ Time Frame: 6 months ]
    Number of initial antibiotic prescriptions not relevant to recommendations divided by the total number of initial antibiotic prescriptions

  2. Rate of initial antibiotherapies not consistent with recommendations [ Time Frame: 6 months ]
    Number of initial antibiotic prescriptions not consistent (molecule, dose, period of time) with recommendations divided by the total number of initial antibiotic prescriptions

  3. Rate of reassessments not relevant to recommendations [ Time Frame: 6 months ]
    Number of antibiotic prescription modifications not relevant to recommendations divided by the total number of antibiotic prescription modifications

  4. Rate of reassessments not consistent with recommendations [ Time Frame: 6 months ]
    Number of antibiotic prescription modifications not consistent (molecule, dose, period of time) with recommendations divided by the total number of antibiotic prescription modifications

  5. Frequence of use of shared medical file [ Time Frame: 6 months ]
    Number of patients for which the shared medical file is used divided by the total number of patients enrolled



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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Sampling Method:   Non-Probability Sample
Study Population
Patients consulting in emergency departments of Toulon La Seyne sur Mer hospital because of a urinary infection and to whom antibiotherapy is prescribed
Criteria

Inclusion Criteria:

  • Every patient more than 18 years who was administered antibiotherapy for urinary infection in emergency department or for whom urinary infection was diagnosed in emergency department (cystitis, acute pyelonephritis, prostatitis)

Exclusion Criteria:

  • Patients less than 18 years old
  • Patients opposed to their data use
  • Patients hospitalized more than 24 hours
  • Patients taking antibiotherapy already before their arrival in emergency department
  • Patients without sufficient reading capacities or understanding of french language to express opposition to their research participation
  • Any other reason which, according to investigator, might interfere with research objective evaluation

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03928951


Contacts
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Contact: Anaïs MAUGARD 04 94 14 55 29 ext +33 Anais.maugardlandre@ch-toulon.fr

Locations
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France
Centre Hospitalier Intercommunal Toulon - La Seyne sur Mer Recruiting
Toulon, Var, France, 83056
Contact: Mouna EL OMRI, MD    0667227459 ext +33    MOUNA.EL-OMRI@ch-toulon.fr   
Sponsors and Collaborators
Centre Hospitalier Intercommunal de Toulon La Seyne sur Mer
Investigators
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Study Director: Mouna EL OMRI, MD Centre Hospitalier Intercommunal Toulon - La Seyne sur Mer

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Responsible Party: Centre Hospitalier Intercommunal de Toulon La Seyne sur Mer
ClinicalTrials.gov Identifier: NCT03928951     History of Changes
Other Study ID Numbers: 2019-CHITS-01
First Posted: April 26, 2019    Key Record Dates
Last Update Posted: July 10, 2019
Last Verified: July 2019
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No

Keywords provided by Centre Hospitalier Intercommunal de Toulon La Seyne sur Mer:
Urinary infections
Antibiotherapy
Emergency
Reassessment

Additional relevant MeSH terms:
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Infection
Communicable Diseases
Urinary Tract Infections
Emergencies
Disease Attributes
Pathologic Processes
Urologic Diseases