Buyle 2010.
| Methods | Study design: ITS | |
| Participants | Physicians Clinical speciality: not clear Level of training: fully trained Setting/country: hospital/inpatient/Belgium |
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| Interventions | The PEM consisted of guidelines for sequential antibiotic therapy (IV to PO with fluoroquinolones) published and disseminated in the local drug letter (October 2003), the official letter of the Pharmacotherapeutic Committee. This intervention was oriented towards all physicians (approximately 650) in the hospital | |
| Outcomes | 1 process outcome: usage of IV versus total fluoroquinolone | |
| Notes | ‐ | |
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Intervention independent of other changes ‐ ITS | Unclear risk | No information was provided |
| Shape of Intervention effect pre‐specified ‐ ITS | Low risk | COMMENT: the authors describe the suitability of fluoroquinolones for IV to PO antibiotic switches and suggest that sequential therapy (which would be reflected by a decrease in the proportion of IV antibiotic out of total antibiotic use (IV + PO)) |
| Intervention unlikely to affect data collection ‐ ITS | Low risk | The intervention (publication/dissemination of guideline in the local drug letter in October 2003) did not affect either the source or method of data collection |
| Blinding of outcome assessors (detection bias) ‐ ITS All outcomes | Low risk | The outcome was objective |
| Incomplete outcome data (attrition bias) ‐ ITS All outcomes | Low risk | COMMENT: the reasons for loss to follow‐up were similar. The number lost was low and similarly distributed between groups (2/36 from control group; 5/45 in total from the 2 intervention groups) |
| Selective reporting (reporting bias) ‐ ITS | Low risk | All relevant outcomes in the methods section were reported in results section |
| Other bias ‐ ITS | High risk | Quote, pg. 408‐409: "the IV/PO ratio may be an indicator for implementing sequential therapy but could be biased by confounding factors. An example of a possible confounding factor is the length of stay of the patients. Patients who are switched to an oral therapy could be discharged earlier as the oral therapy can easily be continued at home. In this case the IV/PO ratio will increase as we only look at the consumption in the hospital" |