Evidence-based Antimicrobial Stewardship: Sustainable Implementation in Primary Care (EASSI-PC)

EASSI-PC is a multi-state implementation trial funded by the Australian Government through the Medical Research Future Fund (MRFF) Clinical Trials Activity grant and led by general practitioners (GPs) and researchers from four Australian universities (Bond University, The University of Melbourne, The University of Newcastle, and Adelaide University). Antibiotic use is the main driver of antibiotic resistance. In Australia, over 10 million people receive antibiotics annually - often for self-limiting infections. Most antibiotics are prescribed in general practice, making primary care central to efforts to reduce antibiotic resistance. Despite strong evidence for antimicrobial stewardship (AMS) interventions, real-world uptake in primary care remains limited. EASSI-PC aims to support GPs to implement evidence-based AMS strategies in real-world clinical settings. The EASSI-PC study is a cluster-randomised, open-label, pragmatic, parallel-group trial conducted in general practices in Queensland, Victoria, New South Wales and South Australia. The study aims to assess whether implementing an integrated, multifaceted package of high-resource-intensive antimicrobial stewardship interventions (enhanced support arm) reduces antibiotic prescribing in general practice compared with a low-resource-intensive package (standard support arm). The standard support intervention consists of passive, self-directed access to antimicrobial stewardship strategies and resources via the EASSI-PC website while the enhanced support package includes additional implementation strategies and support activities. The co-primary outcomes are practice-level prescribing rates of all oral antibiotics and rates of all Pharmaceutical Benefits Scheme-subsidised oral antibiotics dispensed. The scalability and sustainability of these improvements have the potential to embed antimicrobial stewardship into routine general practice, ultimately resulting in better health outcomes and reduced healthcare costs associated with less antibiotic resistance. Go to survey