Novel education-based intervention to reduce inappropriate antibiotic prescribing for treatment of gonorrhoea in China: protocol for a cluster randomised controlled trial

Abstract

IntroductionInappropriate use of antibiotics to treat gonorrhoea can lead to antibiotic resistance. Education programmes may be helpful for improving physician prescribing behaviours in accordance with treatment guidelines. As traditional education based on printed materials may have limited effect on guideline-based treatment, innovative education strategies are needed. The current trial aims to assess the effectiveness of a novel education intervention to increase guideline-based treatment of gonorrhoea in China.Methods and analysisWe will conduct a two-arm cluster randomised control trial at 144 hospitals (clusters) in eight Chinese provinces. The intervention will include an online training video developed on the WenJuanXing platform that covers workflows and requirements for managing a patient with uncomplicated gonorrhoea. Outpatient physicians in dermatology (dermatovenerology), urology, andrology and gynaecology will be given access to the video via a quick response code. In hospitals allocated to the control arm, physicians will continue to participate in their standard of care training programme. The primary outcome is the proportion of gonorrhoea antibiotic prescriptions adherent to Chinese national guidelines at the cluster level. In addition, to understand the reasons of physician’s non-adherence to the intervention by conducting a questionnaire survey will be considered as the secondary outcome of the study.Ethics and disseminationEthical approval was obtained from the Medical Ethics Committee of the Chinese Academy of Medical Sciences Institute of Dermatology (2020-LS-004). All physicians will provide an informed consent prior to participating in the study. Findings of the trial will be disseminated through conferences and peer-reviewed journals, and will be used to develop training programmes for physicians.Trial registration numberChiCTR2000029591.

Increased Involvement of Klebsiellapneumoniae and Enterococcusfaecium in Healthcare-Associated Infections of Intensive Care Units in Taiwan

“…The AMR of CRKP and VREfm significantly increased, which may have contributed to these trends. Although ICPs and antimicrobial stewardship have been implemented for years [7], improvements and aggressive procedures for HAIs in Taiwanese ICUs remain needed.…”

“…All these types of infections exhibit various percentages of antimicrobial resistance (AMR), involving pathogens such as extended-spectrum beta-lactamase generating strains of Enterobacter spp., Escherichia coli, and K. pneumoniae [4], methicillin-resistant S. aureus (MRSA) [5], carbapenem-resistant K. pneumoniae (CRKP), and vancomycin-resistant Enterococcus faecium (VREfm) [6], which can complicate treatment [4][5][6]. The inappropriate use of antibiotics causes AMR [7].…”

Antibiotic Prescribing Patterns in adult patients according to the WHO AWaRe Classification: A multi-facility cross-sectional study in primary healthcare hospitals in Zambia

“…Approximately 20 to 50% of antibiotics are prescribed inappropriately without adhering tothe standard treatment guidelines (STG) [31,33,36]. Therefore, educating prescribers about the rational prescribing of antibiotics is crucial to reducing AMR in the future [37][38][39][40].…”