Evidence map›Paper›PMID 40597774›Full record

Trial reportBMC infectious diseases2025

A prospective cluster randomized trial of an interventions bundle to reduce inappropriate antibiotic use for upper respiratory tract infections in the outpatient setting.

Adeel A Butt, Sherin Shams, Atika Jabeen, Asma Ali Al-Nuaimi, Jeyaram Illiayaraja Krishnan, Aimon B Malik, Samah Saleem, Maryam Hassan Abdulaziz, Naheel Ismail Seyam, Kamran Aziz and 12 more

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06135376 (E-PAUse), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

NCT06135376 naactive not recruitingnot on this map

E-PAUse: Encouraging Proper Antibiotic Use in Outpatient Setting

TypeinterventionalSponsorHamad Medical CorporationRan2023 to 2026Enrolled100,000ConditionsDrug UseArmscomprehensive multi-component interventions
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

22 authors.

Adeel A ButtCorporate Quality and Patient Safety Department, Hamad Medical Corporation, Doha, Qatar. aabutt@hamad.qa.
Sherin ShamsCorporate Quality and Patient Safety Department, Hamad Medical Corporation, Doha, Qatar.
Atika JabeenCorporate Quality and Patient Safety Department, Hamad Medical Corporation, Doha, Qatar.
Asma Ali Al-NuaimiPrimary Health Care Corporation, Doha, Qatar.
Jeyaram Illiayaraja KrishnanPrimary Health Care Corporation, Doha, Qatar.
Aimon B MalikCorporate Quality and Patient Safety Department, Hamad Medical Corporation, Doha, Qatar.
Samah SaleemCorporate Quality and Patient Safety Department, Hamad Medical Corporation, Doha, Qatar.
Maryam Hassan AbdulazizPrimary Health Care Corporation, Doha, Qatar.
Naheel Ismail SeyamPrimary Health Care Corporation, Doha, Qatar.
Kamran AzizPrimary Health Care Corporation, Doha, Qatar.
Dalia KandilPrimary Health Care Corporation, Doha, Qatar.
Anil G ThomasCorporate Quality and Patient Safety Department, Hamad Medical Corporation, Doha, Qatar.
Hanaa Nafady-HegoMicrobiology and Immunology Department, Faculty of Medicine, Assiut University, Assiut, Egypt.
Muzna I LoneCorporate Quality and Patient Safety Department, Hamad Medical Corporation, Doha, Qatar.
Jameela Al AjmiCorporate Quality and Patient Safety Department, Hamad Medical Corporation, Doha, Qatar.
Zain A BhuttaDepartment of Emergency Medicine, Hamad Medical Corporation, Doha, Qatar.
Noora AlSulaitiQatar University College of Medicine, Doha, Qatar.
Wael E Said HusseinPrimary Health Care Corporation, Doha, Qatar.
Sandy SemaanPrimary Health Care Corporation, Doha, Qatar.
Samya Ahmad Al-AbdullaPrimary Health Care Corporation, Doha, Qatar.
Mohamed Ghaith Al-KuwariPrimary Health Care Corporation, Doha, Qatar.
Abdul-Badi Abou-SamraCorporate Quality and Patient Safety Department, Hamad Medical Corporation, Doha, Qatar.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAntibiotic overuse and increasing antimicrobial resistance are global public health threats. We determined the impact of a multicomponent intervention in reducing inappropriate antibiotic use for upper respiratory tract infections (URTIs) in the outpatient setting.

methods

designProspective, cluster-randomized trial.

interventionBundled 4-component intervention including extensive provider education, a decision support algorithm, option for deferred antibiotics prescription, and monthly feedback on prescription patterns, vs. a single randomly assigned intervention (decision support algorithm).

settingFour Primary healthcare centers in Qatar with study period from August 2023 to October 2024.

participantsIndividuals with a diagnosis of URTI who were prescribed antibiotics. MAIN OUTCOME(S): Reduction in inappropriate antibiotic prescriptions for URTIs in the intervention vs. control group during the 11-month follow-up period.

resultsWe analyzed 20,062 episodes-of-care for URTIs with an antibiotic prescription (9,277 at control and 10,785 at intervention sites). In a mixed effects logistic regression model accounting for the clustering effect, the intervention was associated with a 29% reduction in odds of inappropriate antibiotics prescriptions ( [aOR] 0.71; 95% CI 0.66-0.77). The relative reduction was 20.9% (44.9% vs. 35.5%; p < 0.001) between the two groups. The relative drop in inappropriate antibiotic prescriptions before and after the interventions was 16.3% (42.4% vs 35.5%; p < 0.001) at intervention sites (p < 0.001) compared with 2.2% (45.9% to 44.9%; p = 0.4) at control sites. Senior-most physicians and younger population (19-40 years old) were more likely to prescribe or receive inappropriate antibiotic prescription.

conclusionA multi-component intervention can significantly reduce inappropriate antibiotic prescriptions for URTIs in the outpatient setting. CLINICALTRIALS: GOV ID: NCT06135376, Registration Date: November 9, 2023.

Indexed as

Anti-Bacterial AgentsInappropriate PrescribingRespiratory Tract InfectionsAdolescentAdultAgedAntimicrobial StewardshipChildFemaleHumansMaleMiddle AgedOutpatientsProspective StudiesQatarYoung AdultAnti-Bacterial AgentsAntibioticsInappropriatePrimary careUpper respiratory tract infection

Identifiers

PMID40597774
PMCPMC12211981

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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.