Saizy‐Callaert 2003.

Methods	STUDY DESIGN: ITS Risk of Bias: HIGH
Participants	PROVIDERS: all physicians in the hospital PARTICIPANTS: all patients in the hospital CLINICAL PROBLEM: patients requiring antibiotic treatment SETTING: single 600‐bed university hospital in France
Interventions	FORMAT: Interventions: educational meetings and dissemination of protocol; reminders (physical, pocket‐size guideline); restrictive by compulsory order form and expert approval Intervention Functions: education, environmental restructuring, restriction COMPARISON: data for 3 years after implementation of the programme DESIRED CHANGE: reduce excessive
Outcomes	PRESCRIBING: Choice: anti‐infective expenditure per hospital patient
Notes	FINANCIAL SUPPORT: no information ADDITIONAL DATA: no response from authors to request for additional data
Risk of bias
Bias	Authors' judgement	Support for judgement
Intervention independent (ITS) ?	Low risk	4 years' data pre‐ and 3 years' data postintervention, so enough data to account for seasonal change
Analysed appropriately (ITS) ?	Low risk	Re‐analysed. Not done in original paper: comparison of means (uncontrolled before‐after) with Fisher's exact test.
Shape of effect pre‐specified (ITS) ?	Low risk	Done, intended effect was decrease in primary outcome, and point of analysis was point of intervention.
Unlikely to affect data collection (ITS) ?	Low risk	Done, data were from routine systems and unlikely to change over study period.
Knowledge of the allocation adequately prevented(ITS)?	Low risk	Done, data were from routine systems and unlikely to change over study period.
Incomplete outcome data addressed (ITS) ?	High risk	There is no information about change in price of antibiotics over the study period.
Free of selected reporting (ITS) ?	Unclear risk	The intervention was targeted at specific antibiotics, but no information is provided about their use or cost.
Free of other bias (ITS) ?	Unclear risk	No adjustment of antibiotic costs for change in price, so change in price of antibiotics (rather than change in use) over the study period may have been responsible for reduction in cost per patient over the study period. No data about number of admissions pre‐intervention.