Trial reportCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2016
Intervention to improve the quality of antimicrobial prescribing for urinary tract infection: a cluster randomized trial.
Trial report in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01913860 (Supporting the Improvement and Management of Prescribing for Urinary Tract Infections), which is not on this map. Cited by 36 papers, 7 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Supporting the Improvement and Management of Prescribing for Urinary Tract Infections (SIMPle): Protocol for a Randomised Complex Intervention
Who cites it
36 citing papers in PubMed, 7 syntheses or guidelines pooled it, 89 citations in OpenAlex.
- Digital patient safety interventions in primary care: a systematic review and meta-analysis.BMC medicine · 2026Pooled it
- The effects of information technology interventions for optimizing antibiotic prescribing in urinary tract infections: a systematic review.BMC infectious diseases · 2025Pooled it
- Audit and feedback: effects on professional practice.The Cochrane database of systematic reviews · 2025Pooled it
- Audit and Feedback Interventions for Antibiotic Prescribing in Primary Care: A Systematic Review and Meta-analysis.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2025Pooled it
- How effective are social norms interventions in changing the clinical behaviours of healthcare workers? A systematic review and meta-analysis.Implementation science : IS · 2021Pooled it
- Is Non-Steroidal Anti-Inflammatory Therapy Non-Inferior to Antibiotic Therapy in Uncomplicated Urinary Tract Infections: a Systematic Review.Journal of general internal medicine · 2020Pooled it
- The effects of the primary health care providers' prescription behavior interventions to improve the rational use of antibiotics: a systematic review.Global health research and policy · 2020Pooled it
- Self-reported acceptability and feasibility of a multimodal intervention to reduce antibiotic prescriptions for urinary tract infections in primary care: a process evaluation of the RedAres trial among general practitioners and medical practice assistants.BMC health services research · 2025Trial
- Effects of a multimodal intervention in primary care to reduce second line antibiotic prescriptions for urinary tract infections in women: parallel, cluster randomised, controlled trial.BMJ (Clinical research ed.) · 2023Trial
- Feedback of Antibiotic Prescribing in Primary Care (FAPPC) trial: results of a real-world cluster randomized controlled trial in Scotland, UK.The Journal of antimicrobial chemotherapy · 2022Trial
- Action design research to develop an interactive dashboard to visualise and compare patient data from Irish general practice (CARA).BMJ open · 2025Article
- The effect of antimicrobial stewardship interventions upon antimicrobial consumption and appropriateness in Vietnamese district hospitals: a cluster randomised trial.The Lancet regional health. Western Pacific · 2025Article
- How, why and when are delayed (back-up) antibiotic prescriptions used in primary care? A realist review integrating concepts of uncertainty in healthcare.BMC public health · 2024Review
- Acute cystitis in men- a nationwide study from primary care: antibiotic prescriptions, risk factors, and complications.BJGP open · 2024Article
- Antibiotic Stewardship Interventions for Urinary Tract Infections in Outpatient Settings: A Narrative Review.Infectious disease clinics of North America · 2024Review
- Selection of proxy indicators estimating the appropriateness of antibiotic prescriptions in general practice: a national consensus procedure in France.JAC-antimicrobial resistance · 2024Article
- GPs' Perspective on a Multimodal Intervention to Enhance Guideline-Adherence in Uncomplicated Urinary Tract Infections: A Qualitative Process Evaluation of the Multicentric RedAres Cluster-Randomised Controlled Trial.Antibiotics (Basel, Switzerland) · 2023Article
- Sustainability, spread, and scale in trials using audit and feedback: a theory-informed, secondary analysis of a systematic review.Implementation science : IS · 2023Article
- Physician-Targeted Interventions in Antibiotic Prescribing for Urinary Tract Infections in General Practice: A Systematic Review.Antibiotics (Basel, Switzerland) · 2022Review
- How effective is a brief educational intervention on prescribing first-line antibiotics in acute cystitis? A quasi-experimental study among general practitioners in Croatia.Croatian medical journal · 2022Article
Corrections and comments
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundOveruse of antimicrobial therapy in the community adds to the global spread of antimicrobial resistance, which is jeopardizing the treatment of common infections.
methodsWe designed a cluster randomized complex intervention to improve antimicrobial prescribing for urinary tract infection in Irish general practice. During a 3-month baseline period, all practices received a workshop to promote consultation coding for urinary tract infections. Practices in intervention arms A and B received a second workshop with information on antimicrobial prescribing guidelines and a practice audit report (baseline data). Practices in intervention arm B received additional evidence on delayed prescribing of antimicrobials for suspected urinary tract infection. A reminder integrated into the patient management software suggested first-line treatment and, for practices in arm B, delayed prescribing. Over the 6-month intervention, practices in arms A and B received monthly audit reports of antimicrobial prescribing.
resultsThe proportion of antimicrobial prescribing according to guidelines for urinary tract infection increased in arms A and B relative to control (adjusted overall odds ratio [OR] 2.3, 95% confidence interval [CI] 1.7 to 3.2; arm A adjusted OR 2.7, 95% CI 1.8 to 4.1; arm B adjusted OR 2.0, 95% CI 1.3 to 3.0). An unintended increase in antimicrobial prescribing was observed in the intervention arms relative to control (arm A adjusted OR 2.2, 95% CI 1.2 to 4.0; arm B adjusted OR 1.4, 95% CI 0.9 to 2.1). Improvements in guideline-based prescribing were sustained at 5 months after the intervention.
interpretationA complex intervention, including audit reports and reminders, improved the quality of prescribing for urinary tract infection in Irish general practice.
trial registrationClinicalTrials.gov, no. NCT01913860.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.