Interventions to reduce childhood antibiotic prescribing for upper respiratory infections: systematic review and meta-analysis

Abstract

Educational interventions are effective in reducing antibiotic prescribing for childhood URIs. Interventions targeting clinicians and parents are more effective than those for either group alone. The most effective interventions address patient-clinician communication. Studies in low-income to middle-income countries are needed.

Impact of China's essential medicines scheme and zero‐mark‐up policy on antibiotic prescriptions in county hospitals: a mixed methods study

“…A recent trial in the USA showed that use of guidelines, recording justifications for antibiotic use and peer review was effective in reducing inappropriate antibiotic use . We further added interventions at the patient side in a prospective trial as targeting both doctors and patients has shown a larger effect than targeting only one of them, .…”

An informed public's views on reducing antibiotic overuse

“…Our findings regarding limited public understanding about the potential harms of antibiotic overuse are reflected in other studies, which suggest that patients may lack awareness and/or may not view this issue as personally relevant . Furthermore, two systematic reviews of interventions aimed at reducing antibiotic prescriptions for children with respiratory tract infections found that the most effective interventions simultaneously target parents and clinicians . Deliberation participants echoed that interventions should not target patients or physicians alone but also noted that government stakeholders have roles in controlling this problem too.…”

An antibiotic stewardship programme to reduce inappropriate antibiotic prescribing for acute respiratory infections in rural Chinese primary care facilities: study protocol for a clustered randomised controlled trial

“…The stewardship programme includes: (1) building up the antibiotic stewardship leadership, (2) developing operational guidelines, (3) conducting appropriate antibiotic prescribing training with family physicians and village doctors, (4) employing EMR and smart phone apps as reminders and prescription review tools and (5) educating patients during and after consultations. Systematic reviews have shown that broader interventions targeting both health providers and patients achieve the largest effect [6,24]. In this trial, we will target uncomplicated ARIs for all ages which will be more useful to family physicians.…”

“…Interventions addressing inappropriate antibiotic prescribing in primary care that only target patients often show no impact, while effective interventions have employed multi-component strategies that improve the knowledge, attitudes and behaviours of both healthcare providers and patients [20][21][22]. However, most intervention trials have been done in high-income countries [23,24]. We previously developed an intervention to reduce inappropriate antibiotic prescribing for childhood (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14) years old) upper respiratory tract infections (URTIs) in rural, public, primary care facilities known as township hospitals.…”