Antimicrobial Stewardship in Community Pharmacy

University of Toronto

Status: Completed

Conditions: Otitis Media

Treatments: Behavioral: Antimicrobial stewardship; Other: Comparator (no intervention)

Study type: Interventional

Funder types: Other

Identifiers

NCT04219553

34327

Details and patient eligibility

About

Acute otitis media (AOM) is the most common indication for antibiotics for Canadian paediatric patients. As the gatekeepers of safe and effective prescription pharmacotherapy, community pharmacists are well positioned to influence and optimize antibiotic use. The purpose of this project is to develop, implement, and evaluate an antimicrobial stewardship program in the community pharmacy setting that aims to optimize antibiotic use for AOM. This nonrandomized pre-post study includes children aged 6 months to 12 years presenting with an antibiotic prescription for AOM at two community pharmacies in Toronto, Ontario. Participants are excluded if they exhibit signs/symptoms of mastoiditis, have an additional indication for systemic antibiotics, or parents/guardians cannot consent in English. The multifaceted AMS intervention includes pharmacist education, a clinical decision support tool, a parent/guardian questionnaire, and individualized monthly audit and feedback with each pharmacist. Prescriptions are reviewed and adapted by the pharmacist to optimize congruence with 2016 Canadian Paediatric Society AOM guidelines. The primary outcome is the percentage change in guideline congruence attributable to pharmacist intervention. This study will provide insight into the opportunities and barriers of developing large-scale antimicrobial stewardship programs for community pharmacies.

Enrollment: 188 patients

Sex: All

Ages: 6 months to 12 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Prescribed systemic oral antibiotic therapy
• Antibiotics are indicated for the treatment of acute otitis media (AOM) as reported verbally or in writing by parent/guardian or prescriber

Exclusion criteria

• signs/symptoms of mastoiditis
• a diagnosis in addition to AOM for which systemic antibiotics are indicated
• parents/guardians cannot consent to the study in English

Trial design

Primary purpose: Other

Allocation: Non-Randomized

Interventional model: Single Group Assignment

Masking: None (Open label)

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188 participants in 2 patient groups

Retrospective group

Other group

Description:

Comparator group (pre-intervention)

Treatment:

Other: Comparator (no intervention)

Prospective group

Experimental group

Description:

Study group (post-intervention)

Treatment:

Behavioral: Antimicrobial stewardship