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Institute for Implementation Science in Health Care

Swiss National Research foundation supports trial to decrease the use of antibiotics

The Swiss National Research foundation is financing the project “Effectiveness and implementation of point-of-care procalcitonin embedded in a multifaceted implementation strategy to reduce antibiotic prescription in Swiss primary care: the ImpPro hybrid trial” with 720’000 CHF.

The aim of the ImpPro Hybrid Trial is to promote judicious use of antibiotics and thereby prevent development of antimicrobial resistance. In Swiss primary care, antibiotics are frequently prescribed for acute respiratory infections. Globally, antimicrobial stewardship interventions have been shown to reduce antibiotic prescription in primary care, but implementation is a challenge, also in the Swiss context.

One such intervention is the use of point-of-care procalcitonin tests (POC-PCT), which help to distinguish infections of bacterial or viral origin and therefore guide prescribing decisions.

The ImpPro Hybrid Trial aims to understand how an enhanced implementation strategy can increase the uptake of POC-PCT and how this can reduce antibiotic prescriptions in Swiss primary care.

An implementation strategy will be developed, based on antimicrobial stewardship evidence, complemented by context analysis and interviews with stakeholders. Additionally, an electronic tool to document antibiotic prescriptions will be developed, which also allows for individualized feedback to physicians on their prescriptions.

To evaluate intervention effectiveness and implementation success, a hybrid type II effectiveness-implementation study is planned around a cluster-randomized trial.

Professor Lauren Clack of the Institute for Implementation Science in Health Care is co-PI, in collaboration with Dr. Yolanda Müller Chabloz of the Unisanté Center for Primary Care and Public Health at the University of Lausanne, Dr. Noémie Boillat Blanco of the Division des maladies infectieuses des Centre Hospitalier Universitaire Vaudois, and Dr. Catherine Pluess-Suard of the Institute for Infectious Diseases of the University of Bern.

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