The Impact of an Antimicrobial Utilization Program on Antimicrobial Use

The Washington University

Status: Completed

Conditions: Antimicrobial Prescribing Practices

Treatments: Behavioral: Academic Detailing by the Antimicrobial Utilization Team (AUT)

Study type: Interventional

Funder types: Other

Identifiers

NCT00552838

579-2002 Emory IRB

Details and patient eligibility

About

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).

Full 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.

Enrollment: 785 patients

Sex: All

Ages: 18 to 85 years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

Inclusion Criteria:

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

Trial design

785 participants in 1 patient group

A

No Intervention group

Description:

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.

Treatment:

Behavioral: Academic Detailing by the Antimicrobial Utilization Team (AUT)