Cargando…

Comments by Microbiologists for Interpreting Antimicrobial Susceptibility Testing and Improving the Appropriateness of Antibiotic Therapy in Community-Acquired Urinary Tract Infections: A Randomized Double-Blind Digital Case-Vignette Controlled Superiority Trial

In primary care, urinary tract infections (UTIs) account for the majority of antibiotic prescriptions. Comments from microbiologists on interpreting the antimicrobial susceptibility testing (AST) profile for urinalysis were made to improve the prescription of antibiotics. We aimed to explore the add...

Descripción completa

Detalles Bibliográficos
Autores principales: Piet, Emilie, N’Diaye, Youssoupha, Marzani, Johann, Pires, Lucas, Petitprez, Hélène, Delory, Tristan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10451981/
https://www.ncbi.nlm.nih.gov/pubmed/37627692
http://dx.doi.org/10.3390/antibiotics12081272
_version_ 1785095553895366656
author Piet, Emilie
N’Diaye, Youssoupha
Marzani, Johann
Pires, Lucas
Petitprez, Hélène
Delory, Tristan
author_facet Piet, Emilie
N’Diaye, Youssoupha
Marzani, Johann
Pires, Lucas
Petitprez, Hélène
Delory, Tristan
author_sort Piet, Emilie
collection PubMed
description In primary care, urinary tract infections (UTIs) account for the majority of antibiotic prescriptions. Comments from microbiologists on interpreting the antimicrobial susceptibility testing (AST) profile for urinalysis were made to improve the prescription of antibiotics. We aimed to explore the added value of these comments on the quality of antibiotic prescribing by a superior double-blind digital randomized case-vignette trial among French general practitioners (GPs). One case vignette with (intervention) or without (control) a ‘comment’ after AST was randomly assigned to GPs. Among 815 participating GPs, 64.7% were women, at an average age of 37 years. Most (90.1%) used a computerized decision support system for prescribing antibiotics. Empirical antibiotic therapy was appropriate in 71.9% (95% CI, 68.8–75.0) of the cases, without differences between arms. The overall appropriateness of targeted antibiotic therapy (primary outcome) was not significantly increased when providing ‘comments’: 83.4% vs. 79.9% (OR = 1.26, 95% CI, 0.86–1.85). With the multivariate analysis, the appropriateness was improved by 2-folds (OR = 2.38, 95% CI, 1.02–6.16) among physicians working in healthcare facilities. Among digital-affine young general practitioners, the adjunction of a ‘comment’ by a microbiologist to interpret urinalysis in community-acquired UTIs did not improve the overall level of appropriateness of the targeted antibiotic.
format Online
Article
Text
id pubmed-10451981
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-104519812023-08-26 Comments by Microbiologists for Interpreting Antimicrobial Susceptibility Testing and Improving the Appropriateness of Antibiotic Therapy in Community-Acquired Urinary Tract Infections: A Randomized Double-Blind Digital Case-Vignette Controlled Superiority Trial Piet, Emilie N’Diaye, Youssoupha Marzani, Johann Pires, Lucas Petitprez, Hélène Delory, Tristan Antibiotics (Basel) Article In primary care, urinary tract infections (UTIs) account for the majority of antibiotic prescriptions. Comments from microbiologists on interpreting the antimicrobial susceptibility testing (AST) profile for urinalysis were made to improve the prescription of antibiotics. We aimed to explore the added value of these comments on the quality of antibiotic prescribing by a superior double-blind digital randomized case-vignette trial among French general practitioners (GPs). One case vignette with (intervention) or without (control) a ‘comment’ after AST was randomly assigned to GPs. Among 815 participating GPs, 64.7% were women, at an average age of 37 years. Most (90.1%) used a computerized decision support system for prescribing antibiotics. Empirical antibiotic therapy was appropriate in 71.9% (95% CI, 68.8–75.0) of the cases, without differences between arms. The overall appropriateness of targeted antibiotic therapy (primary outcome) was not significantly increased when providing ‘comments’: 83.4% vs. 79.9% (OR = 1.26, 95% CI, 0.86–1.85). With the multivariate analysis, the appropriateness was improved by 2-folds (OR = 2.38, 95% CI, 1.02–6.16) among physicians working in healthcare facilities. Among digital-affine young general practitioners, the adjunction of a ‘comment’ by a microbiologist to interpret urinalysis in community-acquired UTIs did not improve the overall level of appropriateness of the targeted antibiotic. MDPI 2023-08-02 /pmc/articles/PMC10451981/ /pubmed/37627692 http://dx.doi.org/10.3390/antibiotics12081272 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Piet, Emilie
N’Diaye, Youssoupha
Marzani, Johann
Pires, Lucas
Petitprez, Hélène
Delory, Tristan
Comments by Microbiologists for Interpreting Antimicrobial Susceptibility Testing and Improving the Appropriateness of Antibiotic Therapy in Community-Acquired Urinary Tract Infections: A Randomized Double-Blind Digital Case-Vignette Controlled Superiority Trial
title Comments by Microbiologists for Interpreting Antimicrobial Susceptibility Testing and Improving the Appropriateness of Antibiotic Therapy in Community-Acquired Urinary Tract Infections: A Randomized Double-Blind Digital Case-Vignette Controlled Superiority Trial
title_full Comments by Microbiologists for Interpreting Antimicrobial Susceptibility Testing and Improving the Appropriateness of Antibiotic Therapy in Community-Acquired Urinary Tract Infections: A Randomized Double-Blind Digital Case-Vignette Controlled Superiority Trial
title_fullStr Comments by Microbiologists for Interpreting Antimicrobial Susceptibility Testing and Improving the Appropriateness of Antibiotic Therapy in Community-Acquired Urinary Tract Infections: A Randomized Double-Blind Digital Case-Vignette Controlled Superiority Trial
title_full_unstemmed Comments by Microbiologists for Interpreting Antimicrobial Susceptibility Testing and Improving the Appropriateness of Antibiotic Therapy in Community-Acquired Urinary Tract Infections: A Randomized Double-Blind Digital Case-Vignette Controlled Superiority Trial
title_short Comments by Microbiologists for Interpreting Antimicrobial Susceptibility Testing and Improving the Appropriateness of Antibiotic Therapy in Community-Acquired Urinary Tract Infections: A Randomized Double-Blind Digital Case-Vignette Controlled Superiority Trial
title_sort comments by microbiologists for interpreting antimicrobial susceptibility testing and improving the appropriateness of antibiotic therapy in community-acquired urinary tract infections: a randomized double-blind digital case-vignette controlled superiority trial
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10451981/
https://www.ncbi.nlm.nih.gov/pubmed/37627692
http://dx.doi.org/10.3390/antibiotics12081272
work_keys_str_mv AT pietemilie commentsbymicrobiologistsforinterpretingantimicrobialsusceptibilitytestingandimprovingtheappropriatenessofantibiotictherapyincommunityacquiredurinarytractinfectionsarandomizeddoubleblinddigitalcasevignettecontrolledsuperioritytrial
AT ndiayeyoussoupha commentsbymicrobiologistsforinterpretingantimicrobialsusceptibilitytestingandimprovingtheappropriatenessofantibiotictherapyincommunityacquiredurinarytractinfectionsarandomizeddoubleblinddigitalcasevignettecontrolledsuperioritytrial
AT marzanijohann commentsbymicrobiologistsforinterpretingantimicrobialsusceptibilitytestingandimprovingtheappropriatenessofantibiotictherapyincommunityacquiredurinarytractinfectionsarandomizeddoubleblinddigitalcasevignettecontrolledsuperioritytrial
AT pireslucas commentsbymicrobiologistsforinterpretingantimicrobialsusceptibilitytestingandimprovingtheappropriatenessofantibiotictherapyincommunityacquiredurinarytractinfectionsarandomizeddoubleblinddigitalcasevignettecontrolledsuperioritytrial
AT petitprezhelene commentsbymicrobiologistsforinterpretingantimicrobialsusceptibilitytestingandimprovingtheappropriatenessofantibiotictherapyincommunityacquiredurinarytractinfectionsarandomizeddoubleblinddigitalcasevignettecontrolledsuperioritytrial
AT delorytristan commentsbymicrobiologistsforinterpretingantimicrobialsusceptibilitytestingandimprovingtheappropriatenessofantibiotictherapyincommunityacquiredurinarytractinfectionsarandomizeddoubleblinddigitalcasevignettecontrolledsuperioritytrial