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Table 2 Antibiotic prescribing changes among these included studies

From: The effects of the primary health care providers’ prescription behavior interventions to improve the rational use of antibiotics: a systematic review

First author, year

Primary outcome(s)

Change in intervention group

Change in control group

Effect size (95% CI)

P value

Educational interventions

 Llor et al. 2014 [13]

change in the odds ratio of antibiotic prescribing (full intervention group)

  

0.50 (0.44 to 0.57,)

p < 0.001

change in the odds ratio of antibiotic prescribing (partial intervention group)

  

0.99 (0.89 to 1.10)

NR

 Wei et al. 2017 [14]

Antibiotic prescription rate

-42%

-5%

-29%

<0.001

the multiple antibiotic prescription rate

-6%

6%

1%

0.57

the broad-spectrum antibiotic prescription rate

-10%

-5%

-4%

0.3

the intravenous antibiotic prescription rate

-6%

0

-8%

0.07

 Hernandez Santiago et al. 2015 [15]

the rate per 1000 registered patients dispensed one or more 4C antimicrobial prescriptions after 6 months of the intervention

  

-33.5% (–26.1% to –40.9%)

NR

After 12 months of the intervention

  

-42.2%(–34.2% to –50.2%)

NR

After 24 months of the intervention

  

-55.5%(–45.9% to –65.1%)

NR

 Hürlimann et al. 2014 [17]

The percentage of prescriptions of penicillins for all treated RTIs

11.8%

0.7%

11.1%

0.01

the percentage of trimethoprim/ sulfamethoxazole prescriptions for all uncomplicated lower UTIs treated with antibiotics

13.3%

2.7%

10.6%

0.01

 Lemiengre et al. 2018 [16]

Change in immediate antibiotic prescribing (intervention group of POC CRP vs. control)

  

1.01(0.57 to 1.79)

<0.1

Change in immediate antibiotic prescribing (intervention group of BISNA vs. control)

  

2.04 (1.19 to 3.50).

<0.1

Change in immediate antibiotic prescribing (intervention group both POC CRP and BISNA vs. control)

  

1.17 (0.66 to 2.09)

<0.1

Audit and feedback interventions

 Altiner et al. 2007 [18]

the ORs for the prescription of an antibiotic (after 6 weeks of the intervention)

0.58 (0.43 to 0.78), p<0.001

1.52(1.19 to 1.95), p=0.001

  

the ORs for the prescription of an antibiotic (after 12 months of the intervention)

0.72 (0.54 to 0.97), p=0.028

1.31(1.01 to 1.71), p=0.044

  

 Welschen et al. 2004 [20]

Antibiotic prescription rates for acute symptoms of the respiratory tract

-4%

8%

-12%

<0.05

 Gerber et al. 2013 [19]

Rates of broad-spectrum antibiotic prescribing for bacterial ARTIs

-13%

-6%

-7%

=0.1

 van der Velden et al. 2016 [21]

changes in dispensed antibiotics/1000 registered patients (first year)

-7.6%

-0.4%

-7.2%

=0.002

changes in dispensed antibiotics/1000 registered patients (second year)

-4.3%

2%

-6.3%

=0.015

Health policy change strategies

 Xiaoxia 2017 [24]

changes in types of antibiotics

   

<0.01

changes in drug administration of antibiotics

    

changes in combined application of antibiotic

    

 Yip et al. 2014 [23]

Change in antibiotic prescription rates at township health centers

:6.6%

8.4%

-15%

<0.05

Change in antibiotic prescription rates at village posts

-6.0%

10%

-16%

<0.05

 Yang 2014 [22]

Percentage of prescriptions requiring antibiotics for upper respiratory tract infections;

-3.02%;

-0.54%

-2.48%

=0.419

Percentage of prescriptions requiring two or more antibiotics

1.93%

5.65%

-3.72%

=0.049

Information system supported interventions

 Gulliford et al. 2014 [25]

Proportion of consultations with antibiotics prescribed

  

-1.85% (0.1% to 3.59%)

=0.38

the rate of antibiotic prescribing for respiratory tract infections

  

-9.69% (0.75% to 18.63%)

=0.34

 Vellinga et al. 2016 [26]

proportion of antimicrobial prescribing according to guidelines for urinary tract infection (arm A vs. control)

22.8%

-1.70%

24.5%

<0.001

 

proportion of antimicrobial prescribing according to guidelines for urinary tract infection (arm B vs. control)

16.7%

-1.70%

18.4%

<0.001

 Blair 2017 [28]

Antibiotic prescribing rates for children’s RTIs

-12%

-21%

9%

=0.018

 Mainous et al. 2013 [27]

Prescribing of broad-spectrum antibiotics rate

-16.60%

1.10%

-17.70%

<0.0001

Meeker et al. 2016 [29]

The antibiotic prescribing rate for antibiotic-inappropriate acute respiratory tract infection (intervention1 vs. control)

-16%

-11%

-5%

<0.01

The antibiotic prescribing rate for antibiotic-inappropriate acute respiratory tract infection (intervention 2 vs. control)

-18.1%

-11%

-7.1%

<0.01

The antibiotic prescribing rate for antibiotic-inappropriate acute respiratory tract infection (intervention3 vs. control)

-16.3%

-11%

-5.3%

<0.01