6/28/23, 11:40 PM ImpresU Pathway Feedback Search Clinical Topics Home Studies ImpresU ImpresU Disease Disease Disease Acute cystitis Acute pyelonephritis Recurre Trial question What is the role of multifaceted antibiotic stewardship intervention in frail older adults with suspected UTIs? Study design Multi-center Open label RCT Population Characteristics of study participants 71.0% female N = 1041 29.0% male 1041 patients (738 female, 303 male) Inclusion criteria: frail older adults aged 70 of age Key exclusion criteria: participation for < 2 months; in hospice-care; limited life expectancy of 1 month; on antibiotic prophylaxis Interventions N=502 antibiotic stewardship intervention (participatory-action-research approach used for implementation, with sessions for education, evaluation, and local tailoring of the intervention) N=539 usual care (no intervention) Primary outcome Number of antibiotic prescriptions for suspected urinary tract infections 0.6/ p-y 0.58 https://web.pathway.md/studies/reca674ffNONknNJg 1/2 6/28/23, 11:40 PM ImpresU Pathway 0.4/ p-y 0.3/ p-y 0.27 0.1/ p-y Significant decrease 0.0/ p-y Antibiotic stewardship intervention Usual care Significant decrease in the number of antibiotic prescriptions for suspected UTIs (0.27 / p-y vs. 0.58 / p-y; RR 0.42, 95% CI 0.26 to 0.68) Secondary outcomes Significant decrease in antibiotic prescriptions in office hours on day of suspected UTI (0.19 / p-y vs. 0.36 / p-y; RR 0.33, 95% CI 0.19 to 0.57) Significant decrease in suspected UTIs (0.32 / p-y vs. 0.72 / p-y; RR 0.51, 95% CI 0.34 to 0.77) No significant difference in death from all causes (0.26 / p-y vs. 0.26 / p-y; RR 1.03, 95% CI 0.48 to 2.21) Conclusion In frail older adults aged 70 of age, antibiotic stewardship intervention was superior to usual care with respect to number of antibiotic prescriptions for suspected UTIs. Reference Esther A R Hartman, Alma C van de Pol, Silje Rebekka Heltveit-Olsen et al. 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. BMJ. 2023 Feb 22;380:e072319. Open reference URL https://web.pathway.md/studies/reca674ffNONknNJg 2/2