Israeli Judicious Antibiotic Prescription Study (IJAP)

Sheba Medical Center

Status

Completed

Conditions

Antibiotic Use

Carriage of Antibiotic Resistant Pathogens

Treatments

Behavioral: Workshops and focus group meetings

Study type

Interventional

Funder types

Other

Identifiers

NCT01187758

SHEBA-01-2357-GRY-CTIL

Details and patient eligibility

About

This study aims to implement judicious antibiotic prescription habits to primary care pediatricians using a multifacet educational intervention and assess two main outcomes: 1) Direct outcome - prescription rates of the physicians. 2)Indirect outcome - carriage of antibiotic resistant bacteria by the treated population, specifically nasopharyngeal S. pneumoniae, nasal S. aureus and rectal E.coli.

Full description

Background: Bacterial antibiotic resistance is an increasing problem.

Aims: This study aims to implement judicious antibiotic prescription habits among 30 physicians and their treated population as compared to a control group of 30 physicians and their treated population. The outcomes to be measured are:

Change in antibiotic prescriptions to the treated patients of the intervention vs. control physicians during the study period (4years). Change in carriage of antibiotic resistant pathogens, specifically nasopharyngeal penicillin resistant S. pneumoniae,nasal MRSA, and rectal quinolone resistant E. coli.

Study design: All primary care pediatricians of Hashfela district of Macabbi Healthcare services who will agree to participate will be randomly assigned to an intervention or control group. The intervention group will be led by local leaders (primary care physicians from that district) and will take part in educational activities involving annual workshops and quarterly focus group meetings. The intervention is a multifacet intervention that will include guideline preparation, knowledge building, dealing with uncertainties, etc.

The patients of both intervention and control physicians will be screened twice a year for carriage of the bacteria mentioned above. Cross-sectional screening of the treated population will be carried in Summer and winter for 5 consecutive years. Screening will include signing an informed consent, filling a questionnaire and screening with nasal, nasopharyngeal and rectal swabs.

Enrollment

5,700 patients

Sex

All

Ages

Under 5 years old

Volunteers

Accepts Healthy Volunteers

Inclusion criteria

All treated patients of the participating physicians under the age of 5y, who came for any reason for a visit during the study period, who's parents agreed to participate.

Exclusion criteria

The only reason to exclude a child from being recruited was age>5y or refusal of the parent/child to participate.