General Practitioner Reassessment of Urinary Infection Antibiotherapy Prescribed by Emergency Departments (ATB-IU)

General Practitioner Reassessment of the Antibiotherapy of Urinary Infections Initially Treated in Emergency Departments

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.

Study Overview

• Status: Completed
• Conditions: Urinary Tract Infections
• Intervention / Treatment: Other: General practitioner reassessment of urinary infection antibiotherapy prescribed by emergency departments

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 Type: Observational
• Enrollment (Actual): 50

Contacts and Locations

Study Locations

• France
  • Var
    • Toulon, Var, France, 83056
      • Centre Hospitalier Intercommunal Toulon - La Seyne sur Mer

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (ADULT, OLDER_ADULT)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• 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

Description

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

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort	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

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Rate of antibiotherapies modified by general practitioners	Number of antibiotic prescriptions modified by general practitioners divided by the total number of initial antibiotic prescriptions	6 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Rate of initial antibiotherapies not relevant to recommendations	Number of initial antibiotic prescriptions not relevant to recommendations divided by the total number of initial antibiotic prescriptions	6 months
Rate of initial antibiotherapies not consistent with recommendations	Number of initial antibiotic prescriptions not consistent (molecule, dose, period of time) with recommendations divided by the total number of initial antibiotic prescriptions	6 months
Rate of reassessments not relevant to recommendations	Number of antibiotic prescription modifications not relevant to recommendations divided by the total number of antibiotic prescription modifications	6 months
Rate of reassessments not consistent with recommendations	Number of antibiotic prescription modifications not consistent (molecule, dose, period of time) with recommendations divided by the total number of antibiotic prescription modifications	6 months
Frequence of use of shared medical file	Number of patients for which the shared medical file is used divided by the total number of patients enrolled	6 months

Collaborators and Investigators

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

Study record dates

Study Major Dates

• Study Start (ACTUAL): June 14, 2019
• Primary Completion (ACTUAL): September 12, 2019
• Study Completion (ACTUAL): September 12, 2019

Study Registration Dates

• First Submitted: April 24, 2019
• First Submitted That Met QC Criteria: April 24, 2019
• First Posted (ACTUAL): April 26, 2019

Study Record Updates

• Last Update Posted (ACTUAL): November 29, 2019
• Last Update Submitted That Met QC Criteria: November 27, 2019
• Last Verified: November 1, 2019

More Information

Terms related to this study

• Keywords: Emergency; Antibiotherapy; Urinary infections; Reassessment
• Additional Relevant MeSH Terms: Pathologic Processes; Urologic Diseases; Disease Attributes; Emergencies; Infections; Communicable Diseases; Urinary Tract Infections
• Other Study ID Numbers: 2019-CHITS-01

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No