REDuction of Antibiotic RESistance (REDARES) in urinary tract infections using treatments according to national clinical guidelines: study protocol for a pragmatic randomized controlled trial with a multimodal intervention in primary care
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- Background: Urinary tract infections (UTIs) are a common cause of prescribing antibiotics in family medicine. In Germany, about 40% of UTI-related prescriptions are second-line antibiotics, which contributes to emerging resistance rates. To achieve a change in the prescribing behaviour among family physicians (FPs), this trial aims to implement the guideline recommendations in German family medicine. Methods/design: In a randomized controlled trial, a multimodal intervention will be developed and tested in family practices in four regionsBackground: Urinary tract infections (UTIs) are a common cause of prescribing antibiotics in family medicine. In Germany, about 40% of UTI-related prescriptions are second-line antibiotics, which contributes to emerging resistance rates. To achieve a change in the prescribing behaviour among family physicians (FPs), this trial aims to implement the guideline recommendations in German family medicine. Methods/design: In a randomized controlled trial, a multimodal intervention will be developed and tested in family practices in four regions across Germany. The intervention will consist of three elements: information on guideline recommendations, information on regional resistance and feedback of prescribing behaviour for FPs on a quarterly basis. The effect of the intervention will be compared to usual practice. The primary endpoint is the absolute difference in the mean of prescribing rates of second-line antibiotics among the intervention and the control group after 12 months. To detect a 10% absolute difference in the prescribing rate after one year, with a significance level of 5% and a power of 86%, a sample size of 57 practices per group will be needed. Assuming a dropout rate of 10%, an overall number of 128 practices will be required. The accompanying process evaluation will provide information on feasibility and acceptance of the intervention. Discussion: If proven effective and feasible, the components of the intervention can improve adherence to antibiotic prescribing guidelines and contribute to antimicrobial stewardship in ambulatory care.…
Autor(en): | Ildikó GágyorORCiD, Alexandra GreserORCiD, Peter HeuschmannORCiD, Viktoria Rücker, Andy Maun, Jutta BleidornORCiD, Christoph Heintze, Felix Jede, Tim Eckmanns, Anja Klingeberg, Anja Mentzel, Guido SchiemannORCiD |
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URN: | urn:nbn:de:bvb:20-opus-264725 |
Dokumentart: | Artikel / Aufsatz in einer Zeitschrift |
Institute der Universität: | Medizinische Fakultät / Institut für Klinische Epidemiologie und Biometrie |
Medizinische Fakultät / Institut für Allgemeinmedizin | |
Sprache der Veröffentlichung: | Englisch |
Titel des übergeordneten Werkes / der Zeitschrift (Englisch): | BMC Infectious Diseases |
Erscheinungsjahr: | 2021 |
Band / Jahrgang: | 21 |
Aufsatznummer: | 990 |
Originalveröffentlichung / Quelle: | BMC Infectious Diseases (2021) 21:990. https://doi.org/10.1186/s12879-021-06660-0 |
DOI: | https://doi.org/10.1186/s12879-021-06660-0 |
Allgemeine fachliche Zuordnung (DDC-Klassifikation): | 6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit |
Freie Schlagwort(e): | antibiotic resistance; family physicians; guideline adherence; multimodal; primary care; urinary tract infections |
Datum der Freischaltung: | 05.05.2022 |
Open-Access-Publikationsfonds / Förderzeitraum 2021 | |
Lizenz (Deutsch): | CC BY: Creative-Commons-Lizenz: Namensnennung 4.0 International |