[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"health-studies-list:{\"conditionNormalized\":\"pediatric-infectious-disease\",\"overallStatus\":[\"RECRUITING\",\"AVAILABLE\",\"NOT_YET_RECRUITING\"],\"orderBy\":\"LastUpdateSubmitDate:desc\",\"size\":25,\"offset\":0}":3,"health-study-condition:pediatric-infectious-disease":30},{"pageToken":4,"total":5,"offset":6,"count":5,"results":7},null,2,0,[8,44],{"id":9,"slug":10,"hasResults":11,"nctId":12,"briefTitle":13,"officialTitle":14,"acronym":15,"eligibilityCriteria":16,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":19,"enrollmentInfo":20,"targetDuration":4,"studyType":23,"phases":24,"briefSummary":26,"conditions":27,"keywords":4,"overallStatus":31,"whyStopped":4,"lastUpdateSubmitDate":32,"lastUpdatePostDateStruct":33,"startDateStruct":36,"completionDateStruct":38,"leadSponsor":40,"locationsCount":43},"100429750","phase-4-single-dose-intravenous-antibiotics-for-complicated-urinary-tract-infections-in-children-100429750",false,"NCT04876131","Single Dose Intravenous Antibiotics for Complicated Urinary Tract Infections in Children","CHOICE UTI - Clinical Efficacy of Single Dose (Daily) IV Antibiotics Followed by 2 Days Oral Antibiotics Compared to 3 Doses (Daily) IV Antibiotics for Children With Complicated Urinary Tract Infections: a Multicentre Randomised Trial","CHOICE UTI","Inclusion Criteria:\n\n* 3 months (corrected age) to 18 years\n* Fever (reported fever at home or measured fever of ≥38 degrees Celsius associated with the illness that triggered current ED presentation (eg fever may have been 18 hours prior to presentation but none since then because patient has been on maximal antipyretics - paracetamol or ibuprofen)\n* Any of the following complicating features: Vomiting, Rigors, History of recurrent UTI, Urological abnormalities, Tachycardia\n* Urine sample available (Urine culture must have been collected prior to or within an hour of antibiotic treatment, either at the GP or ED - in order to assess urine culture as per below).\n* Abnormal urinary dipstick leucocyte esterase \\>1+ or nitrite positive OR ≥5 White Blood Cells (WBCs) per high-power field in centrifuged urine OR≥ 10 White Blood Cells (WBCs) per mm3 in uncentrifuged urine and bacteriuria with any bacteria per high-power field\n* ED clinician determines the child requires treatment with IV antibiotics \\* In ED, only urine dipstick or urinalysis will be available. Once urine culture is available, to be included in the efficacy analysis, culture results must meet the following criteria: Positive urine culture result with no more than 2 species of microorganisms AND Spontaneously voided urine with ≥105 microorganisms per mL of urine or Suprapubic aspirate or urinary catheter with ≥104 microorganisms per mL of urine. In the absence of a positive urine culture, ultrasonographic findings supporting pyelonephritis (per reporting radiologist) will be accepted as evidence of a urinary tract infection.\n\nExclusion Criteria:\n\n* Sepsis (requiring inotropic support or more than 20ml\u002Fkg of fluid bolus in Emergency Department)\n* Known allergy to all once daily study drug options (gentamicin or ceftriaxone or amikacin)\n* If the patient has another co-existing condition which requires (based on established evidence-based guidelines) more than 1 dose of IV antibiotics eg meningitis\n* Known chronic renal failure or renal transplant patients\n* Unrepaired posterior urethral valves\n* Indwelling stent and fever\n* Previously enrolled participants in the CHOICE UTI trial.\n* No available oral antibiotic option for this UTI: urine culture result already available and multi-resistant organism with susceptibility only to IV antibiotics or known intolerance to oral antibiotics (previous UTI with multi-resistant organism not an exclusion)\n* Previous IV antibiotics for same UTI episode eg interhospital transfer whereby significant time has passed since first dose IV\n* Patients with clinically suspected renal abscess e.g., extreme renal tenderness, out of keeping with pyelonephritis (clinically determined).\n* Clinician does not intend on prescribing a course of IV antibiotics but plans on only giving a single dose from the outset\n* Recurrence of urinary tract infection within 2 weeks\n* Unable to obtain consent\n* Patient is pregnant","ALL","3 Months","18 Years",{"count":21,"type":22},452,"ESTIMATED","INTERVENTIONAL",[25],"PHASE4","Urinary tract infections (UTI) are commonly encountered in children, with 7% diagnosed with at least one UTI by the age of 19 years. The evidence for treatment of uncomplicated UTI is clear; oral antibiotics are as good as intravenous (IV) antibiotics, usually for a total of 7 days. Complicated UTIs (cUTIs) on the other hand, are common reasons for hospital admissions for IV antibiotics and constitute a major burden for healthcare systems. There is considerable variation in care for children who present with UTI and have complicating features such as vomiting, dehydration, urological abnormalities or have a previous history of UTI. Australian and international guidelines lack clear, evidence-based recommendations to guide treatment in this group. Without gold standard evidence, these children will continue to receive unnecessary IV antibiotics, longer hospital stays and poorer health outcomes.\n\nThis multicentre, non-inferiority randomised trial will investigate if One dose - single dose of IV followed by 2 days oral antibiotics is as non-inferior to Three doses for children with UTI and co-existing complicating factors presenting to the Emergency Department (ED). In other words, this study will compare if a single dose of IV antibiotics plus two days oral antibiotics is as clinically effective as 3 doses antibiotics in resolving UTI symptoms at 72 hours after the first dose of IV antibiotics, for complicated UTIs in children presenting to the ED. All participants will receive a total of 7 days of antibiotics for the complicated urinary tract infection. If 1 dose IV and 2 days oral antibiotics is found to be as good as 3 days, the duration of IV antibiotics for complicated UTI can be reduced along with avoidance of the inherent risks of unnecessary hospital admission by administering a single IV dose in an outpatient\u002FED setting. On the other hand if a single IV dose results in prolonged symptoms or treatment failure, this will inform practice for the proportion of children who have a single dose of IV antibiotics in the ED and are sent home on oral antibiotics. Regardless of the outcome, this trial will inform clinical practice for complicated UTI to improve health outcomes for this group.",[28,29,30],"Complicated Urinary Tract Infection","Infection","Pediatric Infectious Disease","RECRUITING","2025-11-25",{"date":34,"type":35},"2025-12-03","ACTUAL",{"date":37,"type":35},"2022-05-30",{"date":39,"type":22},"2028-05-16",{"name":41,"class":42},"Murdoch Childrens Research Institute","OTHER",6,{"id":45,"slug":46,"hasResults":11,"nctId":47,"briefTitle":48,"officialTitle":49,"acronym":50,"eligibilityCriteria":51,"healthyVolunteers":11,"sex":17,"minAge":52,"maxAge":53,"enrollmentInfo":54,"targetDuration":4,"studyType":23,"phases":56,"briefSummary":58,"conditions":59,"keywords":62,"overallStatus":31,"whyStopped":4,"lastUpdateSubmitDate":65,"lastUpdatePostDateStruct":66,"startDateStruct":68,"completionDateStruct":70,"leadSponsor":72,"locationsCount":74},"100518710","interventions-to-de-implement-unnecessary-antibiotic-prescribing-for-children-with-ear-infections-100518710","NCT06034080","Interventions to De-implement Unnecessary Antibiotic Prescribing for Children With Ear Infections","DISAPEAR Trial: Interventions to De-implement Unnecessary Antibiotic Prescribing for Children With Ear Infections","DISAPEAR","Inclusion Criteria:\n\nA. Implementation of Interventions 1. Clinic at a participating organization 2. Provides care to children with AOM 3. Administrative or local approval for participation\n\nB. Secondary Electronic Health Record Data\n\n1. Aged 6 months-17-years-old (inclusive)\n2. Diagnosis of AOM by ICD10 code\n\nC. Video recordings or direct observation of the use of a shared decision aid\n\nParent participation:\n\n1. Child aged 6 months-17 years (inclusive)\n2. Diagnosed with AOM by clinician\n3. Parent or legal guardian is present and is \\>=18 years or older\n\nClinician Participation:\n\n1. Licensed clinician and not a medical trainee\n2. Age 18 \\>= years or older\n\nD. Pre-implementation interviews of clinicians and administrators\n\n1. Licensed clinician (physician or advanced practice clinician) that cares for children with AOM at a participating organization or an administrator\u002Fmanager at a participating organization.\n2. Aged \\>=18 years-no maximum\n\nE. Pre-implementation focus groups of parents\n\n1. Parent or legal guardian of a child aged 6 months-17 years (inclusive) that has had AOM diagnosed at a participating organization.\n2. 18 years of age or older and able\u002Fwilling to consent\n\nF. Parents enrolled for surveys\n\n1\\. Parent or legal guardian of a child aged 6 months-17 years (inclusive) that has had AOM diagnosed at a participating organization. 2. Willing to participate and able to complete electronic surveys at enrollment and 10 days after enrollment. 3. Working phone 4. Age \\>=18 years of age\n\nG. Post-intervention focus groups of parents\n\n1. Parent or legal guardian of a child aged 6 months-17 years (inclusive) that has had AOM diagnosed at a participating organization.\n2. 18 years of age or older and able\u002Fwilling to consent\n\nH. Post-intervention surveys of clinicians and administrators\n\n1. Licensed clinician (physician or advanced practice clinician) that cares for children with AOM at a participating organization or an administrator\u002Fmanager at a participating organization.\n2. Aged \\>=18 years-no maximum\n\nExclusion Criteria:\n\nA. Implementation of Interventions\n\n1\\. Clinics that exclusively provide telehealth\n\nB. Secondary Electronic Health Record Data\n\n1\\. None\n\nC. Video recordings or direct observation of the use of a shared decision aid\n\nParent participation:\n\n1\\. None\n\nClinician Participation:\n\n1\\. None\n\nD. Pre-implementation interviews of clinicians and administrators 1. Medical trainee (student, resident, fellow, etc.)\n\nE. Pre-implementation focus groups of parents\n\n1\\. None\n\nF. Parents enrolled for surveys 1. Complicated or recurrent AOM as determined by the study team\n\nG. Post-intervention focus groups of parents 1. None\n\nH. Post-intervention surveys of clinicians and administrators\n\n1\\. Medical trainee (student, resident, fellow, etc.)","6 Months","17 Years",{"count":55,"type":22},1566,[57],"NA","This study aims to improve care and reduce unnecessary antibiotic prescribing for children with ear infections. The study will compare the effectiveness of a \"gold standard\" to a hybrid intervention combined with this gold standard, in order to identify steps to increase parent satisfaction for child ear infection care. The \"gold standard\" approach is a Health System Level Intervention. On its own, it involves clinician education, tools in electronic medical records, and audit and feedback reports for clinician prescribing habits. The hybrid intervention includes the elements of the health systems level intervention in addition to a Shared Decision-Making component, which allows for both an increase in the role parents play in their child's care, as well as clinician education for how to use this method. The goals of this work are to increase parent satisfaction, reduce antibiotics taken for childhood ear infections, align medical care with the current national guidelines, and evaluate differences in the two intervention groups. Both groups will be evaluated for implementation outcomes to improve dissemination and scalability for future use of these models in antibiotic prescribing for children with ear infections.\n\nThis study will recruit a diverse group of patients and clinicians to complete surveys, parents to participate in focus groups, and clinicians and administrators to be interviewed in order to meet study aims and receive sufficient feedback on the interventions performed. There are two hypotheses for this research: 1. The Hybrid Intervention will have higher parent satisfaction and reduced antibiotic use compared to the Health-System Level Intervention and 2. The Hybrid Intervention will be more challenging to implement than the Health-System Level Intervention, but will be preferred by parents, clinicians, and administrators.",[60,61,30],"Acute Otitis Media","Ear Infection",[63,64],"Shared Decision-Making","Health-System Level Intervention","2025-08-26",{"date":67,"type":35},"2025-09-03",{"date":69,"type":35},"2025-02-03",{"date":71,"type":22},"2029-06",{"name":73,"class":42},"Intermountain Health Care, Inc.",3]