Interventions to Improve Antibiotic Prescribing in Upper Middle Income Countries: A Systematic Review of the Literature 1990 - 2009
Journal Title: Macedonian Journal of Medical Sciences (MJMS) - Year 2013, Vol 6, Issue 1
Abstract
Background: Inappropriate antibiotic use is a global public health problem with serious consequences, including antimicrobial resistance. In response, countries have to take comprehensive action with interventions that improve antibiotic use at various levels. Several reviews have evaluated interventions on antibiotic prescribing practices in different healthcare settings. Objective: To identify interventions targeting antibiotic prescribing by medical doctors in primary health care in upper middle-income countries and to assess intervention effectiveness. Methods: We undertook systematic literature review of studies for the period 1990 – 2009. Studies had to report quantitative data on antibiotic prescribing by primary care doctors using medicines use indicators. Intervention effects were based on data from intervention studies with valid study designs. Results: Eight studies describing ten interventions met all the inclusion criteria. We found that single educational interventions targeting all diseases had low or no impact on percentages of patients prescribed antibiotics. Greater impact on antibiotic prescribing was achieved by multifaceted interventions focusing on specific diseases. Conclusion: The limited evidence on interventions from upper middle-income countries has produced results similar to other reviews. More concerted commitment is needed to monitor antibiotic prescribing regularly and to conduct well designed evaluations of interventions.
Authors and Affiliations
Verica Ivanovska| Utrecht University - Utrecht Institute for Pharmaceutical Sciences, Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht, Netherlands, University , Kathleen Anne Holloway| World Health Organization - WHO Regional Office South East Asia, Delhi, India
Keywords
Related Articles
- EP ID EP8915
- DOI 10.3889/MJMS.1857-5773.2012.0268
- Views 293
- Downloads 15
Quantitative Analysis of Adrenal Cortical Histological Alterations After Application of Medroxyprogesterone Acetate
Aim. The aim of our investigation was to make a quantification of the changes being registered by a quantitative histological analysis of adrenal cortex after long-term application of high doses of medroxyprogesterone...
Evaluation of Soft Tissue Defects’ Reconstruction Using Flaps or Skin Grafts
Background. Removal of damaged tissue and organs followed by replacement with appropriate substitutes was a long- lasting tendency since the ancient times. Skin defects of any aetiology, can be replaced either with skin...
Killer Cell Immunoglobulin-Like Receptor Genes Polymorphisms in Macedonian Patients with Haematological Malignancies
Aim: The aim of this study was to examine the gene frequencies of 16 KIR genes and pseudogenes (KIR2DL1,KIR2DL2,KIR2DL3,KIR2DL4,KIR2DL5,KIR3DL1,KIR3DL2,KIR3DL3,KIR2DS1,KIR2DS2, KIR2DS3, KIR2DS4, KIR2DS5, KIR3DS1, KIR2D...
Analgesic, Anti-Inflammatory and Antiarthritic Activity of Newly Synthesized Bicyclothieno 1, 2, 3 – Triazines
Aim: The present study was aimed to evaluate the novel bicyclo thieno 1, 2, 3-triazines (BTT) namely BTT-1, BTT-2, BTT-3 and BTT-4 for analgesic anti-inflammatory and antiarthritic activity. Materials and Methods: Anal...
Applications of Kite Flap in Reconstruction of Cheek Defects after Tumor Excision
Objectives: The main aim of this study was to present our experience with V-Y island flaps in reconstruction of the cheek defects after tumor excision in 3 facial zones. Patients and methods: 40 patients with cutaneous...