Clinical trial NCT07012083: Adherence to Anti-rabies Post-exposure Prophylactic Protocols
Official title: Egyptian Doctors' Adherence to Anti-rabies Post-exposure Prophylactic Protocols; A Survey Study
Study type: OBSERVATIONAL
Overall status: NOT_YET_RECRUITING
Conditions: Rabies
Lead sponsor: Tanta University
Sponsor class: OTHER
First posted: 2025-06-10
Enrollment: 100
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Observational model: COHORT
Time perspective: CROSS_SECTIONAL
Sampling method: NON_PROBABILITY_SAMPLE
Study population: This cross-sectional survey study will be conducted on a consecutive sample of physicians who treat patients with animal bites potentially requiring post-exposure anti-rabies prophylaxis. The sample will include emergency physicians, general practice or family physicians, and surgeons of both sexes, with varying degrees of experience and post-graduate clinical training.

Brief summary: This study aims to investigate physicians' adherence to Advisory Committee on Immunization Practices (ACIP) guidelines regarding Anti-rabies post-exposure prophylaxis in Egypt.

Detailed description: There is no known effective treatment for rabies, and virtually all cases are fatal. Although the prognosis is poor in patients who develop rabies, the disease is usually preventable with proper wound care and post-exposure prophylaxis. Following a thorough risk assessment, the decision to initiate rabies post-exposure prophylaxis should be made. The risk assessment should consider the type of exposure, local rabies epidemiology in animals, vaccination history of the animal, circumstances of the exposure incident, and the availability of the animal for observation or rabies testing .

The World Health Organization (WHO) and the Advisory Committee on Immunization Practices (ACIP) have adopted guidelines for starting post-exposure prophylaxis (PEP) against rabies. The decision to start Anti-Rabies PEP is usually made in primary health care units or emergency departments .

Lack of adherence to these guidelines might result in unnecessary costs and medical risks, such as injection site reactions and systemic hypersensitivity reactions . This malpractice of inappropriate anti-rabies PEP prescription is not uncommon.

Eligibility criteria: Inclusion Criteria:

* Physicians who treat patients with animal bites potentially requiring post-exposure anti-rabies prophylaxis. The sample will include emergency physicians, general practice or family physicians, and surgeons of both sexes, with varying degrees of experience and post-graduate clinical training.

Exclusion Criteria:

* Incomplete record filling

Primary outcomes:
measure: Adherence to Anti-rabies PEP Guidelines
timeFrame: 6 months
Secondary outcomes:
measure: Health & Economic burden of such malpractice
timeFrame: 9 months
Other outcomes:
Locations:
city: Tanta
country: Egypt
facility: Faculty of Medicine-Tanta University
state: Gharbiya
Study officials:
References:
citation: Catherine M Brown, Alfred DeMaria. Indications for post-exposure rabies prophylaxis In: UpToDate, Connor RF (Ed), Wolters Kluwer. (Accessed on Oct 15, 2024).
citation: Protocol for a well-performed rabies post-exposure prophylaxis delivery: To read along with the decision trees, 1- Wound Risk Assessment and 2 - PEP Risk Assessment. Geneva: World Health Organization; 2024. https://doi.org/10.2471/ B09018.
citation: Rupprecht CE, Briggs D, Brown CM, Franka R, Katz SL, Kerr HD, Lett SM, Levis R, Meltzer MI, Schaffner W, Cieslak PR; Centers for Disease Control and Prevention (CDC). Use of a reduced (4-dose) vaccine schedule for postexposure prophylaxis to prevent human rabies: recommendations of the advisory committee on immunization practices. MMWR Recomm Rep. 2010 Mar 19;59(RR-2):1-9.