SynthesisThe Lancet. Infectious diseases2011
Non-prescription antimicrobial use worldwide: a systematic review.
Synthesis in The Lancet. Infectious diseases, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02900820 (Safety of Discontinuing Patient Antibiotic Treatment When Physicians no Longer Consider it Necessary), which is not on this map. Cited by 444 papers, 13 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Safety of Discontinuing Patient Antibiotic Treatment When Physicians no Longer Consider it Necessary
Who cites it
444 citing papers in PubMed, 13 syntheses or guidelines pooled it.
- Non-prescription antibiotic dispensing in community pharmacies in LMICs: a systematic review of prevalence, drivers, and policy implications.BMC health services research · 2026Pooled it
- Effectiveness of educational interventions in improving antimicrobial dispensing by community pharmacists: a systematic review.BMC medical education · 2025Pooled it
- Drivers of inappropriate use of antibiotics among community members in low- and middle-income countries: a systematic review of qualitative studies.BMC public health · 2025Pooled it
- Interventions to reduce non-prescription antimicrobial sales in community pharmacies.The Cochrane database of systematic reviews · 2025Pooled it
- Non-prescription antibiotic use and its predictors among children in low- and middle-income countries: a systematic review and meta-analysis.Italian journal of pediatrics · 2024Pooled it
- Should my child be given antibiotics? A systematic review of parental decision making in rural and remote locations.Antimicrobial resistance and infection control · 2024Pooled it
- Prevalence and predictors of self-medication with antibiotics in Ethiopia: a systematic review and meta-analysis.Antimicrobial resistance and infection control · 2024Pooled it
- A systematic synthesis of expert opinion on effective policies to tackle bacterial resistance worldwide.Veterinary medicine and science · 2023Pooled it
- Income level and antibiotic misuse: a systematic review and dose-response meta-analysis.The European journal of health economics : HEPAC : health economics in prevention and care · 2022Pooled it
- Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis.Lancet (London, England) · 2022Pooled it
- Education level and misuse of antibiotics in the general population: a systematic review and dose-response meta-analysis.Antimicrobial resistance and infection control · 2022Pooled it
- The vicious cycle of the public's irrational use of antibiotics for upper respiratory tract infections: A mixed methods systematic review.Frontiers in public health · 2022Pooled it
- Antibiotic use and colorectal neoplasia: a systematic review and meta-analysis.BMJ open gastroenterology · 2021Pooled it
- Effectiveness of doctors' advice on non-prescription antibiotic use: a randomized controlled trial, China.Bulletin of the World Health Organization · 2026Trial
- Perception and practice of self-medication with antibiotics among medical students in Sudanese universities: A cross-sectional study.PloS one · 2022Trial
- Taking Charge Against the Silent Pandemic-Electrochemical Characterization of Drug Resistance.Molecules (Basel, Switzerland) · 2026Review
- Comment on: Point-of-care testing in community pharmacies to improve antimicrobial stewardship in respiratory infections: a scoping review of effectiveness, implementation and cost-effectiveness.JAC-antimicrobial resistance · 2026Article
- Public knowledge and misconceptions regarding antibiotic use and resistance in Jordan: A cross-sectional study.Medicine · 2026Article
- Over-the-counter sales of high-priority antibiotics are common: results of a global survey.JAC-antimicrobial resistance · 2026Article
- Non-Cytotoxic Benzyl Triphenyl Phosphonium Bromide Is Bactericidal on MRSA and Fully Inhibits Biofilm Formation by MRSA and MRSE.Pharmaceuticals (Basel, Switzerland) · 2026Article
384 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
In much of the world antimicrobial drugs are sold without prescription or oversight by health-care professionals. The scale and effect of this practice is unknown. We systematically reviewed published works about non-prescription antimicrobials from 1970-2009, identifying 117 relevant articles. 35 community surveys from five continents showed that non-prescription use occurred worldwide and accounted for 19-100% of antimicrobial use outside of northern Europe and North America. Safety issues associated with non-prescription use included adverse drug reactions and masking of underlying infectious processes. Non-prescription use was common for non-bacterial disease, and antituberculosis drugs were available in many areas. Antimicrobial-resistant bacteria are common in communities with frequent non-prescription use. In a few settings, control efforts that included regulation decreased antimicrobial use and resistance. Non-prescription antimicrobial and antituberculosis use is common outside of North America and northern Europe and must be accounted for in public health efforts to reduce antimicrobial resistance.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.