Table 4.
Summary of findings of included studies measuring changes antibiotic prescribing outcomes
| First author, year | Primary outcome(s) | Change in intervention group | Change in control group | Effect size (95% CI) | P value | |
|---|---|---|---|---|---|---|
| Nationwide interventions (n= 3) | ||||||
| Bauraind, 200438 | change in total outpatient antibiotic sales | a | a | first campaign year: −6.5% | < 0.05 | |
| change in total outpatient antibiotic sales | a | a | second campaign year: −3.4% | > 0.05 | ||
| Sabuncu, 200937 | change in winter antibiotic prescribing rate (Oct to Mar) | a | a | −26.5% (−33.5% to −19.6%)b | < 0.0001 | |
| Bernier, 201436 | change in antibiotic prescribing rate | a | a | −30% (−36.3% to −23.8%)c | < 0.001 | |
| Community-level interventions (n = 7) | ||||||
| Belongia, 200528 | change in antimicrobial prescribing rate | −20.4%, | −19.8% | −0.6% | NR | |
| change in retail sales of antimicrobial drugs (grams per capita) | −17.3% | −27.4% | 10.1% | NR | ||
| Samore, 200533 | change in antibiotic prescribing rate per 100 person-years (partial intervention vs. control) | 1% | 6% | −5% | 0.03 (difference between three groups) | |
| change in antibiotic prescribing rate per 100 person-years (full intervention vs. control) | −10% | 6% | −16% | |||
| Rubin, 200534 | change in proportion of upper RTIs episodes treated with an antibiotic | −15.6% (P = 0.002) | −1.5% (P = 0.47) | −14.1% | NR | |
| Hennessy, 200232 | change in mean number of antibiotic courses per person | −31% (P = < 0.01) | −10% (P ≥ 0.05) | −21% | NR | |
| Lambert, 200740 | change in antibiotic prescribing rate | 21.7 fewer items prescribed per 1000 populationd | NR | −5.8% | < 0.0005 | |
| Gonzales, 200831 | net change in antibiotic dispenses per 1000 persons | – | – | −3.8% | 0.30 | |
| net change in managed care-associated antibiotic dispenses per 1000 members | – | – | −8.8% | 0.03 | ||
| Formoso, 201335 | average change in antibiotic prescribing rates for outpatient | – | – | −4.3% (−7.1% to − 1.5%) | 0.008 | |
| Site-based/household interventions (n = 2) | ||||||
| Gonzales, 199929 | change in antibiotic prescribing rate for uncomplicated acute bronchitis (limited intervention vs. control) | −5% | −2% | −3% | 0.02 (full-intervention vs. limited intervention and control) | |
| change in antibiotic prescribing rate for uncomplicated acute bronchitis (full intervention vs. control) | −26% | −2% | −24% | |||
| Gonzales, 200530 | change in antibiotic prescribing rate for adult bronchitis (intervention vs. local control) | −24% | −10% | −14% | 0.006 | |
| change in antibiotic prescribing rate for adult bronchitis (intervention vs. distal control) | −24% | −7% | −17% | < 0.002 | ||
NR, not reported.
a
Not reported as ITS design.
b
During campaign periods (Oct to Mar) 2002 to 2007.
c
Maximum significant decrease observed during campaign periods (Oct to Mar) 2002 to 2010.
d
Over winter months (Nov to Mar).