Antimicrobial Stewardship for Primary Care Pediatricians (PARTI)

Children's Hospital of Philadelphia (CHOP)

Status: Completed

Conditions: Acute Sinusitis; Viral Infection; Pneumonia; Streptococcal Pharyngitis

Treatments: Behavioral: Antimicrobial Stewardship Bundle

Study type: Interventional

Funder types: Other

Identifiers

NCT01806103

HHSA2900200710013 (Other Grant/Funding Number)

09-007305

Details and patient eligibility

About

The purpose of the study is to determine if physician education coupled with audit and feedback of antibiotic prescribing can improve antibiotic prescribing by primary care clinicians.

Full description

Using a large, diverse pediatric primary care network sharing a comprehensive electronic health record (EHR), a cluster-randomized trial will be performed to determine the effectiveness of an outpatient antimicrobial stewardship bundle, including treatment guidelines coupled with audit and feedback of physician prescribing, to curb inappropriate antibiotic prescribing for respiratory tract infections.

Aim 1: To determine the impact of an outpatient antimicrobial stewardship bundle within a pediatric primary care network on antibiotic prescribing for conditions for which antibiotics are not indicated.

Hypothesis: Antimicrobial stewardship will decrease rates of antibiotic prescribing for conditions for which antibiotics are not indicated.

Aim 2: To determine the impact of an outpatient antimicrobial stewardship bundle within a pediatric primary care network on broad-spectrum antibiotic prescribing for conditions for which narrow-spectrum antibiotics are indicated.

Hypothesis: Antimicrobial stewardship will decrease the rate of broad-spectrum antibiotic prescribing for conditions for which narrow-spectrum antibiotics are indicated.

Enrollment: 170 patients

Sex: All

Volunteers: No Healthy Volunteers

Inclusion criteria

• Primary care pediatric practices within the CHOP Care Network

Exclusion criteria

• Academic primary care pediatric practices within the CHOP Care Network
• Providers entering a practice after the start of the intervention
• Providers with less than 25 antibiotic prescriptions in the 6 months prior to the start of the intervention

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Single Group Assignment

Masking: None (Open label)

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170 participants in 2 patient groups

Antimicrobial Stewardship Bundle

Experimental group

Description:

An intervention "bundle" to reduce outpatient antibiotic use in children will include education, creation of and access to guidelines, and audit of and feedback on individual prescribing within the context of achievable benchmarks.

Treatment:

Behavioral: Antimicrobial Stewardship Bundle

Control

No Intervention group

Description:

Control sites will be within strata to maintain balance of treatment arm within strata