N/A
N=525
Audit-and-feedback to Improve Antimicrobial-prescribing Among Urologists
Urologic Diseases · Antibacterial Drug Adverse Reaction
Bottom Line
View on ClinicalTrials.gov: NCT04196777 ↗Enrolled (actual)
525
Serious AEs
16.6%
Results posted
Sep 2024
Primary outcome: Primary: Percentage of Cases Who Received Excessive Post-procedural Antimicrobials — 216; 644 Participants — p=0.004
Study Design & Population
- Study type
- Interventional
- Phase
- N/A
- Interventions
- Audit-and-feedback (Behavioral)
- Age
- Pediatric, Adult, Older Adult
- Sex
- All
- Sponsor
- Iowa City Veterans Affairs Medical Center
- Primary completion
- Jul 2023
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Percentage of Cases Who Received Excessive Post-procedural Antimicrobials |
216; 644 | 0.004 sig |
| SECONDARY Excessive Post-procedural Antimicrobial Duration (Mean) |
4.1; 5.3 | 0.001 sig |
| SECONDARY Percentage of Cases Who Received a Late Antimicrobial Prescription |
83; 169 | 0.04 sig |
| SECONDARY Percentage of Cases Who Were Re-admitted to the Hospital or Presented to an Emergency Department or an Urgent Care Clinic |
113; 186 | <0.01 sig |
| SECONDARY Percentage of Cases Who Died (Mortality) |
4; 4 | — |
| SECONDARY Percentage of Cases Who Underwent Clostridioides Difficile Testing |
1; 6 | — |
| SECONDARY Percentage of Cases Who Acquired Clostridioides Difficile Infection |
0; 0 | — |
Summary
Antimicrobial resistance is one of today''s most urgent public health problems. An important strategy to slow the spread of antimicrobial resistance is the promotion of judicious antimicrobial use. There are many opportunities to reduce unnecessary antimicrobial-prescribing, including in patients undergoing surgical procedures. The following study will specifically study opportunities to improve antimicrobial use in patients undergoing common urologic procedures at hospitals in the Veterans Health Administration (VHA).
Guidelines recommend giving antibiotics for no more than 24-hours after most urologic procedures, but the investigators have shown that the unnecessary use of post-procedural antimicrobials is common in this setting. In a national cohort of nearly 30,000 VHA patients, excessive post-procedural antimicrobials were prescribed after 37.2% of urologic procedures for a median duration of 3.0 excess days.
In this study, the investigators will evaluate whether giving regular feedback to providers at 3 VHA hospitals can reduce unnecessary antimicrobial use after urologic procedures.
Eligibility Criteria
Inclusion Criteria
- A practicing urologist at an intervention site, OR
- A member of the antimicrobial stewardship team at an intervention site
Exclusion Criteria: None
Data sourced from ClinicalTrials.gov (NCT04196777). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.