[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"health-studies-list:{\"conditionNormalized\":\"antimicrobial-stewardship\",\"overallStatus\":[\"RECRUITING\",\"AVAILABLE\",\"NOT_YET_RECRUITING\"],\"orderBy\":\"LastUpdateSubmitDate:desc\",\"size\":25,\"offset\":0}":3,"health-study-condition:antimicrobial-stewardship":27},{"pageToken":4,"total":5,"offset":6,"count":5,"results":7},null,3,0,[8,49,80],{"id":9,"slug":10,"hasResults":11,"nctId":12,"briefTitle":13,"officialTitle":14,"acronym":4,"eligibilityCriteria":15,"healthyVolunteers":11,"sex":16,"minAge":17,"maxAge":4,"enrollmentInfo":18,"targetDuration":4,"studyType":21,"phases":22,"briefSummary":24,"conditions":25,"keywords":29,"overallStatus":36,"whyStopped":4,"lastUpdateSubmitDate":37,"lastUpdatePostDateStruct":38,"startDateStruct":41,"completionDateStruct":43,"leadSponsor":45,"locationsCount":48},"100611919","diagnostic-stewardship-intervention-to-reduce-inappropriate-antibiotic-use-for-urinary-tract-infections-in-primary-care-100611919",false,"NCT07246837","Diagnostic Stewardship Intervention to Reduce Inappropriate Antibiotic Use for Urinary Tract Infections in Primary Care","A Randomized Controlled Trial of a Diagnostic Stewardship Intervention to Reduce Inappropriate Antibiotic Use for Urinary Tract Infections in Primary Care","Inclusion Criteria:\n\n* Adults (≥18 years) undergoing urine culture as part of routine outpatient care\n* Able to provide informed consent\n* English- and or Spanish-speaking.\n\nExclusion Criteria:\n\n* Presence of a urinary catheter\n* Inability to read and sign the informed consent\n* Unable to follow study procedures (due to significant visual, auditory, physical or cognitive impairment).","ALL","18 Years",{"count":19,"type":20},252,"ESTIMATED","INTERVENTIONAL",[23],"NA","Urine culture is the most common microbiological test in the outpatient setting in the United States. Unfortunately, contamination during collection is prevalent and undermines test accuracy, leading to incorrect diagnosis, unnecessary treatment, wasted laboratory resources, and inflated costs. Unnecessary antibiotic treatment increases the risk of developing antimicrobial resistance, one of the most serious threats to patients and public health. The goal of this clinical trial is to test whether a bilingual (English and Spanish) educational intervention, an animated video and pictorial flyer, can reduce urine culture contamination and associated inappropriate antibiotic use in adult patients visiting safety-net primary care clinics.\n\nThe main questions it aims to answer are:\n\n1. Does providing patients with a bilingual educational intervention reduce urine culture contamination rates?\n2. Does the intervention lead to fewer unnecessary urinary antibiotic prescriptions?\n3. Does providing patients with a bilingual educational intervention reduce contaminated urinalyses? Researchers will compare patients randomized to receive the educational intervention (video and flyer) to those receiving usual care to see if the intervention improves urine collection accuracy and reduces inappropriate antibiotic use. Participants will watch a short, animated video with step-by-step instructions for proper midstream clean-catch urine (MSCC) collection, receive a pictorial flyer (with stills from the video) reinforcing the instructions, and provide a urine sample for culture. Hypothesis: patients who receive the educational intervention will have: lower urine culture contamination rates (primary outcome), fewer urinary antibiotic prescriptions (secondary outcome), and fewer contaminated urinalyses (secondary outcome). The objectives are to (1) develop educational tools: Create an animated video and pictorial flyer with step-by-step urine collection instructions for women and men, developed through an iterative, stakeholder-engaged process, (2) assess acceptability: Use mixed methods (quantitative surveys and qualitative interviews) to evaluate and refine the tools for usability and cultural\u002Flinguistic appropriateness, and (3) test effectiveness: Conduct a randomized controlled trial to assess the intervention's impact on urine contamination rates, antibiotic prescribing, and patient satisfaction.",[26,27,28],"Urinary Tract Infection(UTI)","Antimicrobial Stewardship","Primary Care",[30,31,32,33,34,27,28,35],"Urinary Tract Infection","UTI","Inappropriate Antibiotic Use","Diagnostic Stewardship","Antibiotic Resistance","Randomized Controlled Trial","RECRUITING","2026-02-11",{"date":39,"type":40},"2026-02-13","ACTUAL",{"date":42,"type":40},"2026-01-22",{"date":44,"type":20},"2028-05-31",{"name":46,"class":47},"Baylor College of Medicine","OTHER",1,{"id":50,"slug":51,"hasResults":11,"nctId":52,"briefTitle":53,"officialTitle":54,"acronym":55,"eligibilityCriteria":56,"healthyVolunteers":11,"sex":16,"minAge":17,"maxAge":4,"enrollmentInfo":57,"targetDuration":4,"studyType":21,"phases":59,"briefSummary":60,"conditions":61,"keywords":64,"overallStatus":36,"whyStopped":4,"lastUpdateSubmitDate":70,"lastUpdatePostDateStruct":71,"startDateStruct":73,"completionDateStruct":75,"leadSponsor":77,"locationsCount":79},"100600127","quality-improvement-intervention-for-a-safe-antimicrobial-use-reduction-in-critically-ill-patients-100600127","NCT07093450","Quality Improvement Intervention for a Safe Antimicrobial Use Reduction in Critically Ill Patients","Estudo de Implementação de Melhoria de Qualidade Para Redução do Uso de Antimicrobianos em Unidades de Terapia Intensiva","SAFE-REDUCE","Intensive care units inclusion Criteria:\n\n* ICU leadership acceptance to participant in the quality improvement intervention;\n* Hospital infection control leadership acceptance to participant in the quality improvement intervention;\n* ICU participation in the IMPACTO-MR platform with high quality data;\n* ICU potential for quality improvement based on a subjective assessment of the ICU and hospital infection leaderships\n\nIntensive care units exclusion Criteria:\n\n\\- Absence of local IRB approval\n\nParticipants inclusion Criteria:\n\n* All patients admitted to the intensive care unit\n\nParticipants exclusion Criteria:\n\n* Patients younger than 18 years-old will be excluded from individual-level analysis",{"count":58,"type":20},9000,[23],"The goal of this clinical trial is to learn if an educational intervention with audit and feedback on physicians and health care professionals who participate in antimicrobial treatment decisions can reduce the use of antimicrobials in adult patients admitted to a sample of Brazilian intensive care units (ICUs). The educational intervention is based on a literature review of current recommendations for a more rational use of antimicrobials and microbiological tests in daily ICU practice.\n\nThe main questions it aims to answer are:\n\n* Does the educational intervention reduce the antimicrobial consumption in the intensive care units?\n* Does this educational intervention aiming to reduce antimicrobial utilization in accordance with the latest guidelines have any safety signals regarding ICU mortality rates or ICU length-of-stay?\n\nResearchers will compare (1) ICUs sequentially randomized to this quality improvement educational intervention aimed at improving antimicrobial utilization to (2) the same ICUs at months where the educational intervention has not been delivered yet.\n\nEach participant ICU will transition to the quality improvement intervention approximately each month, starting at July, 2025. This quality improvement intervention is based on current recommendations for antimicrobial stewardship from regulatory agencies and medical societies, including cognitive aids for physicians to improve decision-making regarding the commencement of antimicrobials, their duration and antimicrobial time-outs. The investigators hypothesize that intensivists (ICU doctors) need to embrace antimicrobial stewardship as a core competence of their daily activities.",[62,27,63],"Infection","Critically Ill Intensive Care Unit Patients",[65,66,62,67,68,69],"Antimicrobial stewardship","Intensive care unit","Stepped-wedge cluster trials","Hybrid effectiveness-implementation trials","Diagnostic stewardship","2025-11-25",{"date":72,"type":40},"2025-12-03",{"date":74,"type":40},"2025-06-01",{"date":76,"type":20},"2026-07",{"name":78,"class":47},"Hospital Sirio-Libanes",9,{"id":81,"slug":82,"hasResults":11,"nctId":83,"briefTitle":84,"officialTitle":85,"acronym":86,"eligibilityCriteria":87,"healthyVolunteers":88,"sex":16,"minAge":17,"maxAge":4,"enrollmentInfo":89,"targetDuration":4,"studyType":91,"phases":4,"briefSummary":92,"conditions":93,"keywords":94,"overallStatus":99,"whyStopped":4,"lastUpdateSubmitDate":100,"lastUpdatePostDateStruct":101,"startDateStruct":103,"completionDateStruct":105,"leadSponsor":107,"locationsCount":4},"100567326","evidence-based-quality-improvement-for-prescribing-stewardship-in-icu-equips-icu-100567326","NCT06666738","Evidence Based QUality Improvement for Prescribing Stewardship in ICU (EQUIPS-ICU)","Evidence Based QUality Improvement for Prescribing Stewardship in ICU: Can a Structured Antimicrobial Review be Implemented in LMIC ICUs?","EQUIPS-ICU","Inclusion Criteria:\n\n* All adult ICUs within CCAA-affiliated Care Quality Registries\n* ICUs must appoint a named Champion to facilitate implementation\n* All antimicrobial prescriptions for adult patients within the ICUs described above\n\nExclusion Criteria:\n\n• ICU's which demonstrate adoption and reach of 80% or greater (median over 2 months) of a pre-existing structured antimicrobial review",true,{"count":90,"type":20},6300,"OBSERVATIONAL","The goal of this observational study is to learn about the implementation of a process to review antimicrobial prescriptions for adult patients in Intensive Care Unit (ICU).\n\nThe main question it aims to answer is: can a structured antimicrobial review can be implemented in ICUs?\n\nImplementation will be supported by the use of local protocols, audit and feedback, and education. It will be evaluated by daily data collection of clinical processes and interviews with local champions.\n\nResources to conduct the study are provided by the Wellcome Flagship Innovations award. (\"Collaboration for Research, Implementation and Training in Critical Care in Asia and Africa\", reference 224048\u002FZ\u002F21\u002FZ).",[27],[95,27,96,97,98],"Critical care","Implementation","Quality improvement","Low or Middle Income Country (LMIC)","NOT_YET_RECRUITING","2024-10-30",{"date":102,"type":40},"2024-10-31",{"date":104,"type":20},"2024-11",{"date":106,"type":20},"2025-09",{"name":108,"class":47},"University of Oxford"]