Reducing Antibiotic Prescribing in Family Practice
ConditionAcute Respiratory Tract Infection
Trial statusNot yet recruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age6+
SponsorSeattle Children's Hospital
About this trial
Antibiotic prescribing for childhood acute respiratory tract infections (ARTIs), including acute otitis media (AOM), pharyngitis, sinusitis, bronchitis, and upper respiratory infection (URI), is common in the United States (US). In the outpatient setting, more than 50% of children diagnosed with ARTIs receive antibiotic prescriptions. Considering that the estimated US prevalence of pediatric bacterial ARTIs is 27% (with the remainder of ARTIs caused by viruses) this represents a substantial degree of antibiotic overuse nationwide. Another troubling trend in antibiotic prescribing for ARTIs in children is the increased reliance on broad-spectrum, second-line agents for bacterial ARTIs. Unwarranted use of antibiotics, especially broad-spectrum agents, has been associated with increased resistance among several strains of bacteria that commonly cause ARTIs, posing risks to both individuals and communities.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Children or adults with acute respiratory tract infections (ARTIs) defined as bacterial (acute otitis media [AOM], pharyngitis, and sinusitis) or viral (bronchitis and viral upper respiratory infection [URI]) based on their common etiologies.
Seven months old and older
Disqualifiers
None
Trial design
Design model
Parallel
Treatments tested in this trial
DART QI Program Participation
Other interventionAntibiotic prescribing data will be collected at multiple time points both before and after the initiation of the intervention.
Treatment groups
180 Participants
are divided into 2 treatment groupsGroup A: Intervention Group ProvidersActive comparator 1 intervention
Group B: Control Group ProvidersNo intervention 0 interventions
Trial outcomes
Primary outcomes
1
Overall antibiotic prescribing rates for pediatric and adult ARTIs.
The primary outcome of overall antibiotic prescribing rates for ARTIs will be assessed by calculating the number of eligible ARTI visits occurring within a measurement period (measure denominator) where antibiotics were prescribed (numerator). This outcome will be assessed separately for the eligible pediatric (6 months to 17 years-old) and adult (\> 18 years-old) patients.
Time frame
The primary outcomewill be collected for all participating providers (both intervention and control) during a 30-month period beginning with baseline data collection.Secondary outcomes
1
First-line antibiotic prescribing rates for pediatric and adult bacterial ARTIs.
The secondary outcome of first-line antibiotic prescribing rates for bacterial ARTIs will be assessed by calculating the number of eligible bacterial ARTI visits occurring within a measurement period (measure denominator) where first-line antibiotics were prescribed (numerator). This outcome will be assessed separately for the eligible pediatric (6 months to 17 years-old) and adult (\> 18 years-old) patients.
Time frame
The secondary outcome will be collected for all participating providers (both intervention and control) during a 30-month period beginning with baseline data collection.2
Net cost of delivering the DART QI program
The net cost of delivering the intervention will be calculated as the difference between the total costs (sum of antibiotic prescription, intervention delivery, and return visit utilization costs) in the intervention and control groups.
Time frame
This outcome will be collected for all participating providers (both intervention and control) during a 30-month period beginning with baseline data collection.Locations
Sponsors and contacts
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Source ClinicalTrials.gov
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