Improving antibiotic prescribing for women with E. coli urinary tract infections

Selective Reporting for Antibiotic Susceptibility Testing and GPs' Prescribing of Broad-spectrum Antibiotics in Women With E. Coli UTIs

This study is testing a new way to help doctors prescribe the right antibiotics for women with E. coli urinary tract infections to reduce the use of broad-spectrum antibiotics.

Quick facts

• Phase: NA
• Study type: Interventional
• Enrollment: 3000 (estimated)
• Ages: 18 Years and up
• Sex: Female
• Sponsor: Nantes University Hospital (other)
• Locations: 1 site (Nantes)
• Trial ID: NCT06067386 on ClinicalTrials.gov

What this trial studies

This study aims to reduce inappropriate prescriptions of broad-spectrum antibiotics for urinary tract infections (UTIs) in women by implementing selective reporting for antibiotic susceptibility testing. By focusing on the specific resistance profiles of E. coli, the study seeks to guide general practitioners in making more informed prescribing decisions. The intervention involves disseminating a tailored report that highlights effective antibiotics based on susceptibility testing results, potentially leading to a significant decrease in broad-spectrum antibiotic use. The study will assess the impact of this approach on antibiotic prescribing practices in primary care settings.

Who should consider this trial

Good fit: Ideal candidates for this study are women aged 18 and older with a positive urine culture for E. coli who have been prescribed antibiotics by a general practitioner.

Not a fit: Patients who have been hospitalized or received antibiotics from healthcare institutions in the specified timeframe may not benefit from this study.

Why it matters

Potential benefit: If successful, this approach could significantly reduce antibiotic resistance and improve treatment outcomes for women with UTIs.

How similar studies have performed: Previous studies have shown that selective reporting of antibiotic susceptibility can lead to a significant reduction in inappropriate antibiotic prescriptions, indicating a promising approach.

Eligibility criteria

Inclusion Criteria:

Patients :

* women ≥18 years of age,
* affiliated with the CPAM of Loire Atlantique (44) or Maine et Loire (49),
* with a urine culture: i) analyzed by LabOuest, ii) positive for E. coli, and iii) associated with a prescription for antibiotics by a general practitioner in the period 7 days before and 14 days after the antibiotic susceptibility testing.

General practitioners :

* practicing in primary care Loire Atlantique (44) and/or Maine et Loire (49),
* having been consulted by at least 100 different patients in the 12 months prior to baseline,
* having received at least one urine culture result for a woman ≥18 years of age analyzed by LabOuest over the 12 months prior to baseline.

Exclusion Criteria:

Patients :

* hospitalized in the period 7 days before and 14 days after antibiotic susceptibility testing (data on antibiotics dispensed in healthcare institutions are not accessible via DCIR data),
* with reimbursements for antibiotics prescribed by physicians in different practices over the period 7 days before and 14 days after antibiotic susceptibility testing.

General practitioners :

* with a special practice (acupuncture, allergology, angiology).
* not receiving any urine culture results analyzed by a laboratory of the LabOuest network in the year following the intervention

Where this trial is running

Nantes

• University Hospital — Nantes, France (RECRUITING)

Study contacts

• Study coordinator: Jean-Pascal FOURNIER, Doctor

Conditions: Urinary Tract Infections, Antibiotic therapy, General practice, Primary care, Public health