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LIBRIS Formathandbok  (Information om MARC21)
FältnamnIndikatorerMetadata
00006005naa a2200649 4500
001oai:gup.ub.gu.se/333098
003SwePub
008240528s2023 | |||||||||||000 ||eng|
0247 a https://gup.ub.gu.se/publication/3330982 URI
0247 a https://doi.org/10.1136/bmj-2022-0723192 DOI
040 a (SwePub)gu
041 a eng
042 9 SwePub
072 7a ref2 swepub-contenttype
072 7a art2 swepub-publicationtype
1001 a Hartman, Esther A R4 aut
2451 0a Effect of a multifaceted antibiotic stewardship intervention to improve antibiotic prescribing for suspected urinary tract infections in frail older adults (ImpresU): pragmatic cluster randomised controlled trial in four European countries.
264 c 2023-02-22
264 1b BMJ,c 2023
520 a To evaluate whether antibiotic prescribing for suspected urinary tract infections in frail older adults can be reduced through a multifaceted antibiotic stewardship intervention.Pragmatic, parallel, cluster randomised controlled trial, with a five month baseline period and a seven month follow-up period.38 clusters consisting of one or more general practices (n=43) and older adult care organisations (n=43) in Poland, the Netherlands, Norway, and Sweden, from September 2019 to June 2021.1041 frail older adults aged 70 or older (Poland 325, the Netherlands 233, Norway 276, Sweden 207), contributing 411 person years to the follow-up period.Healthcare professionals received a multifaceted antibiotic stewardship intervention consisting of a decision tool for appropriate antibiotic use, supported by a toolbox with educational materials. A participatory-action-research approach was used for implementation, with sessions for education, evaluation, and local tailoring of the intervention. The control group provided care as usual.The primary outcome was the number of antibiotic prescriptions for suspected urinary tract infections per person year. Secondary outcomes included the incidence of complications, all cause hospital referrals, all cause hospital admissions, all cause mortality within 21 days after suspected urinary tract infections, and all cause mortality.The numbers of antibiotic prescriptions for suspected urinary tract infections in the follow-up period were 54 prescriptions in 202 person years (0.27 per person year) in the intervention group and 121 prescriptions in 209 person years (0.58 per person year) in the usual care group. Participants in the intervention group had a lower rate of receiving an antibiotic prescription for a suspected urinary tract infection compared with participants in the usual care group, with a rate ratio of 0.42 (95% confidence interval 0.26 to 0.68). No differences between intervention and control group were observed in the incidence of complications (<0.01 v 0.05 per person year), hospital referrals (<0.01 v 0.05), admissions to hospital (0.01 v 0.05), and mortality (0 v 0.01) within 21 days after suspected urinary tract infections, nor in all cause mortality (0.26 v 0.26).Implementation of a multifaceted antibiotic stewardship intervention safely reduced antibiotic prescribing for suspected urinary tract infections in frail older adults.ClinicalTrials.gov NCT03970356.
650 7a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Allmänmedicin0 (SwePub)302242 hsv//swe
650 7a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex General Practice0 (SwePub)302242 hsv//eng
650 7a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Geriatrik0 (SwePub)302222 hsv//swe
650 7a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Geriatrics0 (SwePub)302222 hsv//eng
650 7a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Infektionsmedicin0 (SwePub)302092 hsv//swe
650 7a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Infectious Medicine0 (SwePub)302092 hsv//eng
653 a Aged
653 a Humans
653 a Anti-Bacterial Agents
653 a therapeutic use
653 a Frail Elderly
653 a Antimicrobial Stewardship
653 a Respiratory Tract Infections
653 a drug therapy
653 a Urinary Tract Infections
653 a drug therapy
7001 a van de Pol, Alma C4 aut
7001 a Heltveit-Olsen, Silje Rebekka4 aut
7001 a Lindbæk, Morten4 aut
7001 a Høye, Sigurd4 aut
7001 a Lithén, Sara Sofia4 aut
7001 a Sundvall, Pär-Danielu Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa,CARe - Centrum för antibiotikaresistensforskning,Institute of Medicine, School of Public Health and Community Medicine,Centre for antibiotic resistance research, CARe4 aut0 (Swepub:gu)xsupar
7001 a Sundvall, Sofia4 aut
7001 a Snaebjörnsson Arnljots, Egillu Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa,Institute of Medicine, School of Public Health and Community Medicine4 aut
7001 a Gunnarsson, Ronny K,d 1955u Gothenburg University,Göteborgs universitet,CARe - Centrum för antibiotikaresistensforskning,Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa,Centre for antibiotic resistance research, CARe,Institute of Medicine, School of Public Health and Community Medicine4 aut0 (Swepub:gu)xgunro
7001 a Kowalczyk, Anna4 aut
7001 a Godycki-Cwirko, Maciek4 aut
7001 a Platteel, Tamara N4 aut
7001 a Groen, Wim G4 aut
7001 a Monnier, Annelie A4 aut
7001 a Zuithoff, Nicolaas P4 aut
7001 a Verheij, Theo J M4 aut
7001 a Hertogh, Cees M P M4 aut
7102 a Göteborgs universitetb Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa4 org
7730 t BMJ (Clinical research ed.)d : BMJg 380q 380x 0959-535Xx 1756-1833
8564 8u https://gup.ub.gu.se/publication/333098
8564 8u https://doi.org/10.1136/bmj-2022-072319

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