A cluster-randomized trial across 45 Siriraj general wards found that a sticker reminder increased intravenous-to-oral fluoroquinolone conversion from 42.2% to 58.8% among 168 patients. Cure, mortality, stay, and treatment duration did not differ, but the small trial cannot establish clinical equivalence or safety in every subgroup.
Key findings
- ITT conversion was 58.8% with stickers versus 42.2% with control (p=0.03); among those meeting all criteria, modified-ITT conversion was 69.0% versus 48.5% (p=0.01). Clinical cure, in-hospital mortality, length of stay, and IV or oral fluoroquinolone duration did not significantly differ.
Why this matters globally
A simple prompt may suit resource-constrained hospitals and reduce stewardship communication burden, but effects depend on workflow, eligibility rules, and prescribing culture.
Thai researcher contribution
Siriraj medicine, pharmacy, and clinical-trial teams designed a Thai ward-based intervention and evaluated it through ward-level randomization.
Limitations to consider
One center and 168 patients leave clinical outcomes underpowered. The abstract does not report intracluster correlation, cluster adjustment, between-ward contamination, or specific adverse events. NCT07361185 was retrospectively registered on 22 January 2026 after the study period, limiting prospective checks for outcome switching.