Table 2.
Summary of interventions of the included studies.
| Author (year) | Implementation a | Implementation Period | Results c | ||
|---|---|---|---|---|---|
| Baseline | Post-Implementation | Follow-up | |||
| [57] Stewart et al. (2000) | I | 6 months (Oct 1995–Mar 1996) | 6 months (Oct 1996–Mar 1997) | n.d | AP(+) |
| [25] Wilson et al. (2003) | G | 1 year | 2 year | n.d | QA (+) 1 |
| [26] Thamlikitkul and Apisitwittaya (2003) | G | 3 months | 3months | n.d | QA (+); AP(+) 2 |
| [37] Pagaiya and Garner (2005) | G | n.d | 6 months | n.d | QA (+); CP(+) |
| [48] Razon et al. (2005) | G | 4 months (Nov 1999–Feb 2000) | 4 months 4 months (Nov 2000–Feb 2001) | n.d | QA (+) |
| [51] Rautakorpi et al. (2006) | I 1 | 1 week (Nov 1998) | 1 week (Nov 2001) | 1 week (Nov 2001) | AP (±) 3 |
| [52] Shrestha et al. (2006) | G 2 | 4months (Feb–May 2002) | 4months (Oct 2002–Jan 2003) | n.d | AP (-), QA (-), CP (-) |
| [53] Camacho et al. (2007) | G 2 | 5 days (July) | 5 days (Sept) | 28 days | QA (-), CP (+) |
| [54] Brimkulov et al. (2009) | G 2 | 1 week (Nov) | 1 week (Dec) | 1 month | QA (+), CP (+) |
| [55] Smeets et al. (2009) | I 3 | 6 months | 6 months | 6 months | QA (-), AP (-) |
| [56] Reyes-Morales et al. (2009) | I 3 | n.d | 3 months | n.d | AP (+) |
| [28] Me’emary et al. (2009) | G 2 | 5 days (Dec) | 5days (Jan) | 30 days | QA (+), CP (+) |
| [27] Bjerrum et al. (2011) | I 4 | 3 weeks (winter 2008) | 3 weeks (winter 2009) | n.d | QA (±) 4, AP (+) |
| [29] Angoulvant et al. (2011) | G | 1 year | 3 years | n.d | QA (+) |
| [30] Dommergues and Hentgen (2012) | G | 5 years | 5 years | n.d | QA (+) |
| [31] Gerber et al. (2013) | G | 20 months | 12 months | n.d | AP (+) 5 |
| [32] Grover et al. (2013) | I 5 | n.d | 2 months and 2 days | n.d | QA (+) |
| [33] Gjelstad et al. (2013) | I 3 | 3 months | 1 year | 1 year | QA(+); AP(+) 6 |
| [34] Angoulvant et al. (2013) | G | 2 years | 1 year | n.d | AP (+) 7; QA (+) |
| [58] Boonyasiri and Thamlikitkul (2014) | I 3 | 4 months | 4 months | n.d | QA (+) |
| [35] Meeker et al. (2014) | G 6 | 9 months | 3 months | n.d | AP (+) |
| [36] Zimmerman et al. (2014) | I 5 | 3 months | 6 months | n.d | QA (+) |
| [38] Urrusuno et al. (2014) | G | 1 year | 1 year | n.d | AP (+) |
| [39] van Buul et al. (2015) | I | 1 year (July 2010–June 2011) | 18 months (Jan–sept 2012 and Jan–sept 2013) | n.d | AP (-) |
| [40] Hingorani et al. (2015) | G | 4 years | 5 months | n.d | AP (+) |
| [41] van der Velden et al. (2015) | I 3 | 1 year | 1 year | 1 year | AP (+), QA (+) |
| [42] Ferrat et al. (2016) | G | 3 months | 3 months per year (5 years) | n.d | QA (+), CP (-) |
| [43] Dyrkorn et al. (2016) | G | 1 year | 1 year | n.d | AP (+) |
| [44] Magin et al. (2017) | I 3 | 2 years | 1 year | n.d | QA(±) 8 |
| [45] Ouldali et al. (2017) | G | 2 years | 3 years | n.d | AP (+), QA (+) |
| [47] Molero et al. (2018) | I 4 | 15 days (2008) | 15 days (2009) | 15 days (2015) | AP (+) |
| [46] Sloane et al. (2019) | I 5 | 4 months | 18 months | 6 months | QA (-) |
| [49] Wei et al. (2019) | I 7 | 3 months | 6 months | 12 months | AP (+), QA (+), CP (+) |
| [50] Aoybamroong et al. (2019) | G | 6 months | 6 months | n.d | AP (+) |
a I—broader intervention including guideline implementation; G—guidelines implementation as main focus. 1 MIKSTRA program; 2 Practical Approach to Lung Health (PAL) guidelines; 3 multifaceted intervention; 4 Health Alliance for prudent antibiotic prescribing in patients with respiratory tract infections (HAPPY AUDIT) a multifaceted intervention program; 5 quality improvement program; 6 guideline nudging; 7 antibiotic stewardship program. c QA—rates and quantity of antibiotics prescribed for patients with RTI; AP—rates of appropriate antibiotics prescribed for patients with RTI; CP—differences in cost prescriptions. 1 The average yearly prescribing decreased significantly in the intensive intervention group and increased in the moderate intervention group, (p = 0.026); 2 There was a significant reduction in use of amoxicillin, co-trimoxazole, roxithromycin, and doxycycline; and penicillin V was prescribed significantly more often; 3 Use of first-line antibiotics increased for all infections, and the change was significant for sinusitis (P < 0.001), acute bronchitis (P < 0.015); 4 A significant reduction in the antibiotic prescribing rate was found in the Baltic countries and Hispano-America, while no significant change was seen in the Nordic countries; 5 Broad-spectrum antibiotic prescribing considered off guidelines, and significantly decreased; 6 less use of non-penicillin V antibiotics; 7 The percentage of amoxicillin prescriptions increased dramatically during the study; The percentages of amoxicillin-clavulanate and cefpodoxime prescriptions decreased; 8 Reduced antibiotic prescribing for acute bronchitis/bronchiolitis but not for URTIs.