{
  "abstract": "Introduction Delayed antibiotic prescribing (DAP) has demonstrated efficacy in reducing inappropriate antibiotic use for uncomplicated respiratory tract infections (uRTIs) in primary care across high-income countries. However, evidence regarding its effectiveness in low-income and middle-income countries remains limited. This cluster-randomised controlled trial (cRCT) aims to evaluate the effectiveness of DAP for optimising antibiotic use in primary healthcare institutions (PHIs) in China.Methods and analysis We designed a pragmatic, multicentre, open-label, three-arm cRCT in adult patients with uRTIs. The study will involve 12 PHIs in Korla City of China. Participating institutions will be randomised at a 1:1:1 ratio to three parallel arms: (1) DAP-intervention arm, (2) Immediate antibiotic prescribing comparator arm and (3) Usual care (observational arm). The primary outcome is symptom duration. Secondary outcomes include symptom severity, antibiotic use, adverse events, patient satisfaction and patient belief regarding antibiotic efficacy.Ethics and dissemination Ethics committee approval of this study was obtained from Peking University Institution Review Board (IRB00001052-24169). The findings will be disseminated through peer-reviewed publications and presentations at scientific conferences.Trial registration number ChiCTR2500097330.",
  "authors": [
    {
      "affiliations": [
        "Pharmacy Administration and Clinical Pharmacy, Peking University Health Science Centre, Beijing, China"
      ],
      "name": "Shuo Chen"
    },
    {
      "affiliations": [
        "Pharmacy Administration and Clinical Pharmacy, Peking University Health Science Centre, Beijing, China"
      ],
      "name": "Weihsin Ko"
    },
    {
      "affiliations": [
        "Pharmacy Administration and Clinical Pharmacy, Peking University Health Science Centre, Beijing, China"
      ],
      "name": "Weibin Li"
    },
    {
      "affiliations": [
        "Pharmacy Administration and Clinical Pharmacy, Peking University Health Science Centre, Beijing, China"
      ],
      "name": "Ruowei Xiao"
    },
    {
      "affiliations": [
        "Pharmacy Administration and Clinical Pharmacy, Peking University Health Science Centre, Beijing, China"
      ],
      "name": "Fenqi Du"
    },
    {
      "affiliations": [
        "Pharmacy Administration and Clinical Pharmacy, Peking University Health Science Centre, Beijing, China"
      ],
      "name": "Jing Zhang"
    },
    {
      "affiliations": [
        "Pharmacy Administration and Clinical Pharmacy, Peking University Health Science Centre, Beijing, China"
      ],
      "name": "Suriguga Wu"
    },
    {
      "affiliations": [
        "Institute of Clinical Pharmacology, Peking University First Hospital, Beijing, China"
      ],
      "name": "Bo Zheng"
    },
    {
      "affiliations": [
        "The Centre for Antimicrobial Optimisation (CAMO), Imperial College London, London, UK",
        "The Fleming Initiative, Imperial College London, London, England, UK",
        "School of Health and Medical Sciences, University of London, London, England, UK"
      ],
      "name": "Nina Jiayue Zhu"
    },
    {
      "affiliations": [
        "The Centre for Antimicrobial Optimisation (CAMO), Imperial College London, London, UK",
        "The Fleming Initiative, Imperial College London, London, England, UK",
        "School of Health and Medical Sciences, University of London, London, England, UK"
      ],
      "name": "Raheelah Ahmad"
    },
    {
      "affiliations": [
        "Primary Care and Population Science, University of Southampton, Southampton, England, UK"
      ],
      "name": "Paul Little"
    },
    {
      "affiliations": [
        "Pharmacy Administration and Clinical Pharmacy, Peking University Health Science Centre, Beijing, China",
        "International Research Centre for Medicinal Administration (IRCMA), Peking University, Beijing, China"
      ],
      "name": "Xiaodong Guan"
    },
    {
      "affiliations": [
        "Pharmacy Administration and Clinical Pharmacy, Peking University Health Science Centre, Beijing, China",
        "International Research Centre for Medicinal Administration (IRCMA), Peking University, Beijing, China"
      ],
      "name": "Luwen Shi"
    },
    {
      "affiliations": [
        "Pharmacy Administration and Clinical Pharmacy, Peking University Health Science Centre, Beijing, China",
        "International Research Centre for Medicinal Administration (IRCMA), Peking University, Beijing, China"
      ],
      "name": "Haishaerjiang Wushouer"
    }
  ],
  "title": "Study protocol for evaluating delayed antibiotic prescribing to promote rational antibiotic use in primary healthcare institutions in China: a pragmatic, multicentre, open-label, clustered-randomised controlled trial",
  "uid": "87d36541-787e-5d42-a2fa-10a3f7105b49"
}