Behavioral Economics Strategies for Antibiotic Duration in Skin Infections
(SSTIBE Trial)
What You Need to Know Before You Apply
What is the purpose of this trial?
This trial explores new strategies to help doctors determine the appropriate duration for prescribing antibiotics for skin infections. It compares a new approach, which includes a Default Duration order Panel with pre-set antibiotic durations for specific conditions, to the usual method where doctors select the duration themselves. The study aims to improve treatment for skin conditions such as cellulitis (a common skin infection), impetigo (a skin rash), and abscesses (pockets of pus). Individuals treated for these conditions at Nationwide Children's Hospital might be suitable candidates. As an unphased trial, this study offers participants the chance to contribute to innovative research that could enhance antibiotic prescribing practices.
Do I need to stop my current medications for this trial?
The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.
What prior data suggests that these behavioral economics strategies are safe for altering clinician behavior?
Research shows that for skin and soft tissue infections (SSTIs), a 5 to 7-day antibiotic course is usually sufficient. This shorter treatment can be effective and helps prevent antibiotic overuse. Studies have found that most patients take antibiotics for less than 7 days, indicating that shorter treatments are becoming more common and are generally well-tolerated.
In this clinical trial, researchers are testing a system that suggests antibiotic duration based on the type of skin infection. Previous tests of this system have shown it helps avoid unnecessarily long antibiotic treatments. It adheres to the 5 to 7-day guideline, aligning with current medical advice.
Regarding safety, this approach focuses on adjusting the duration of antibiotic use, not the type or amount. Since antibiotics are commonly used and the treatment duration is within recommended limits, this method is considered safe based on current practices. No specific safety issues related to adjusting the duration have been reported.12345Why are researchers excited about this trial?
Researchers are excited about this trial because it explores a new way to optimize antibiotic use for skin infections using behavioral economics strategies. Unlike standard care, which often leaves antibiotic duration to the discretion of the prescriber, the intervention introduces a default duration in the electronic medical record system. This approach encourages prescribers to choose shorter, evidence-based durations, potentially reducing unnecessary antibiotic use and combating antibiotic resistance. By streamlining the decision-making process, this method could make prescribing more efficient and improve patient outcomes.
What evidence suggests that this trial's strategies could be effective for altering antibiotic prescription duration for skin infections?
This trial will compare two approaches to prescribing antibiotics for skin infections. The control arm involves clinics using a basic Epic order panel where clinicians must manually enter antibiotic duration. The intervention arm involves clinics using a fully functional Epic order panel with set default durations: 5 days for cellulitis and drained abscess, and 7 days for impetigo and undrained abscess. Research has shown that using a standard time frame for prescribing antibiotics for skin infections might not significantly reduce the duration of prescriptions. One study found no clear effect on reducing longer antibiotic use for skin and soft tissue infections (SSTIs). However, evidence supports shorter treatments of 5 to 7 days for these infections, despite the common use of longer treatments. The aim of these standard settings is to encourage doctors to prescribe these shorter, recommended durations. While this method seems promising, current data does not strongly prove it changes prescription habits.12346
Who Is on the Research Team?
Kali Broussard, MD
Principal Investigator
Nationwide Children's Hospital
Joshua Watson, MD
Principal Investigator
Nationwide Children's Hospital
Are You a Good Fit for This Trial?
This trial is for patients at Nationwide Children's Hospital primary care clinics with certain skin and soft tissue infections (like cellulitis, abscesses, or impetigo) who have been prescribed oral antibiotics. It excludes very young infants, those with specific conditions like hidradenitis suppurativa, bites from animals or humans, foreign body-related infections, burns, or weakened immune systems.Inclusion Criteria
Exclusion Criteria
Timeline for a Trial Participant
Screening
Participants are screened for eligibility to participate in the trial
Treatment
Implementation of behavioral economics strategies in antibiotic prescription for skin and soft tissue infections
Follow-up
Participants are monitored for safety and effectiveness after treatment
What Are the Treatments Tested in This Trial?
Interventions
- Default Duration order Panel
Find a Clinic Near You
Who Is Running the Clinical Trial?
Nationwide Children's Hospital
Lead Sponsor