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General Practitioner Reassessment of Urinary Infection Antibiotherapy Prescribed by Emergency Departments

  • Clinicaltrials.gov identifier

    NCT03928951

  • Recruitment Status

    Completed

  • First Posted

    April 26, 2019

  • Last update posted

    November 29, 2019

Study Description

Brief summary:

Urinary infections are at the origin of many emergency department consultations and antibiotic prescriptions. Increase of bacteria resistance to antibiotics is promoted by an inappropriate use of those antibiotics but initial prescription in emergency departments is complicated by brief clinical examinations, unavailable sampling results and risks of multi-resistant bacteria. Large diffusion of new recommendations for urinary infection management should improve the quality of initial antibiotic prescription. However emergency physicians have no knowledge of the reassessment of antibiotherapy 48 to 72 hours after initial prescription by general practitioners which is a quality criterion of good antibiotic use. The main purpose of this study is to estimate the reassessment rate by general practitioners of the urinary infection antibiotherapies prescribed in emergency departments. This will allow assessing the quality of initial antibiotic prescription and help to improve practices.

  • Condition or Disease:Urinary Tract Infections
  • Intervention/Treatment: Other: General practitioner reassessment of urinary infection antibiotherapy prescribed by emergency departments
  • Phase: N/A

Detailed Description

Urinary infections are at the origin of many emergency department consultations and antibiotic prescriptions. Increase of bacteria resistance to antibiotics is promoted by an inappropriate use of those antibiotics but initial prescription in emergency departments is complicated by brief clinical examinations, unavailable sampling results and risks of multi-resistant bacteria. Large diffusion of new recommendations for urinary infection management should improve the quality of initial antibiotic prescription. However emergency physicians have no knowledge of the reassessment of antibiotherapy 48 to 72 hours after initial prescription by general practitioners which is a quality criterion of good antibiotic use. The main purpose of this study is to estimate the reassessment rate by general practitioners of the urinary infection antibiotherapies prescribed in emergency departments. Patients will be informed during their consultation in one of Toulon - La Seyne sur Mer hospital emergency departments. If they don't express opposition to their data collection, they will be included. A form will then be completed by emergency physicians with initial prescribed antibiotherapy, patients' general practitioners contact information and if patients have a shared medical file or not. 4 to 5 days later, patients' general practitioners will be contacted to know if urinary analysis results were transferred from emergency department to practitioners, if antibiotherapy was modified and if patients' shared medical file was consulted.

Study Design

  • Study Type: Observational
  • Actual Enrollment: 50 participants
  • Observational Model: Cohort
  • Time Perspective: Prospective
  • Official Title: General Practitioner Reassessment of the Antibiotherapy of Urinary Infections Initially Treated in Emergency Departments
  • Actual Study Start Date: June 2019
  • Actual Primary Completion Date: September 2019
  • Actual Study Completion Date: September 2019

Groups and Cohorts

Groups/Cohorts Intervention/treatment
: Patients suffering from urinary infection
Patients consulting in one of Toulon - La Seyne sur Mer hospital emergency departments because of urinary infection
Other: General practitioner reassessment of urinary infection antibiotherapy prescribed by emergency departments
Antibiotherapy will be prescribed by emergency physicians and general practitioners will be contacted 4 to 5 days later to know if antibiotherapy was modified

Outcome Measures

  • Primary Outcome Measures: 1. Rate of antibiotherapies modified by general practitioners [ Time Frame: 6 months ]
    Number of antibiotic prescriptions modified by general practitioners divided by the total number of initial antibiotic prescriptions
  • Secondary Outcome Measures: 1. Rate of initial antibiotherapies not relevant to recommendations [ Time Frame: 6 months ]
    Number of initial antibiotic prescriptions not relevant to recommendations divided by the total number of initial antibiotic prescriptions
  • 2. Rate of initial antibiotherapies not consistent with recommendations [ Time Frame: 6 months ]
    Number of initial antibiotic prescriptions not consistent (molecule, dose, period of time) with recommendations divided by the total number of initial antibiotic prescriptions
  • 3. Rate of reassessments not relevant to recommendations [ Time Frame: 6 months ]
    Number of antibiotic prescription modifications not relevant to recommendations divided by the total number of antibiotic prescription modifications
  • 4. Rate of reassessments not consistent with recommendations [ Time Frame: 6 months ]
    Number of antibiotic prescription modifications not consistent (molecule, dose, period of time) with recommendations divided by the total number of antibiotic prescription modifications
  • 5. Frequence of use of shared medical file [ Time Frame: 6 months ]
    Number of patients for which the shared medical file is used divided by the total number of patients enrolled

Eligibility Criteria

  • Ages Eligible for Study: 18 Years and older (Adult, Older Adult)
  • Sexes Eligible for Study: All
  • Accepts Healthy Volunteers: No
  • Sampling Method: Non-Probability Sample
  • Study Population: Patients consulting in emergency departments of Toulon La Seyne sur Mer hospital because of a urinary infection and to whom antibiotherapy is prescribed

Criteria

Inclusion Criteria:

- Every patient more than 18 years who was administered antibiotherapy for urinary
infection in emergency department or for whom urinary infection was diagnosed in
emergency department (cystitis, acute pyelonephritis, prostatitis)

Exclusion Criteria:

- Patients less than 18 years old

- Patients opposed to their data use

- Patients hospitalized more than 24 hours

- Patients taking antibiotherapy already before their arrival in emergency department

- Patients without sufficient reading capacities or understanding of french language to
express opposition to their research participation

- Any other reason which, according to investigator, might interfere with research
objective evaluation

Contacts and Locations

Contacts

Locations

France, Var
Centre Hospitalier Intercommunal Toulon - La Seyne sur Mer
Toulon

Sponsors and Collaborators

Centre Hospitalier Intercommunal de Toulon La Seyne sur Mer

Investigators

Study Director: Mouna EL OMRI, MD Centre Hospitalier Intercommunal Toulon - La Seyne sur Mer

More Information

  • Responsible Party: Centre Hospitalier Intercommunal de Toulon La Seyne sur Mer
  • ClinicalTrials.gov Identifier: NCT03928951 History of Changes
  • Other Study ID Numbers: 2019-CHITS-01
  • First Posted: April 26, 2019 Key Record Dates
  • Last Update Posted: November 29, 2019
  • Last Verified: November 2019
  • Individual Participant
    Data (IPD) Sharing
    Statement:

  • Plan to Share IPD: No
  • Studies a U.S. FDA-regulated Drug Product: No
  • Studies a U.S. FDA-regulated Device Product: No
  • Keywords provided by Centre Hospitalier Intercommunal de Toulon La Seyne sur Mer: Urinary infections
    Emergency
    Reassessment
    Antibiotherapy
  • Additional relevant MeSH terms: Emergencies
    Infection
    Communicable Diseases
    Urinary Tract Infections