期刊
BMC INFECTIOUS DISEASES
卷 21, 期 1, 页码 -出版社
BMC
DOI: 10.1186/s12879-021-06660-0
关键词
Antibiotic resistance; Urinary tract infections; Guideline adherence; Multimodal; Family physicians; Primary care
资金
- Projekt DEAL
- Innovation Committee of the Federal Joint Committee (G-BA) in Germany [01VSF18053]
- University of Wuerzburg
This study aims to change prescribing behavior among family physicians in Germany, specifically focusing on reducing the use of second-line antibiotics. A multimodal intervention will be implemented, with evaluation of the intervention effect after 12 months to improve adherence to antibiotic prescribing guidelines.
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 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.
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