SynthesisBMC infectious diseases2014
A systematic review and meta-analysis of the effects of antibiotic consumption on antibiotic resistance.
Synthesis in BMC infectious diseases, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 608 papers, 9 of them syntheses that pooled it.
What it found
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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.
Procalcitonin to Guide Antibiotic Stop in Neurocritical Care Patients. An Interventional Matched-cohort Study.
Infectious Diseases Experts as Part of the Antibiotic Stewardship Team in Primary Care: a Cluster-randomised Blinded Study (IDASP)
Reducing Empiric VAncomycin Use in Pediatric Suspected Sepsis (REVAMP-Sepsis)
Who cites it
608 citing papers in PubMed, 9 syntheses or guidelines pooled it.
- Pooled it
- Ceftazidime with avibactam for treating severe aerobic Gram-negative bacterial infections: technology evaluation to inform a novel subscription-style payment model.Health technology assessment (Winchester, England) · 2024Pooled it
- Surveillance of antimicrobial utilization in Africa: a systematic review and meta-analysis of prescription rates, indications, and quality of use from point prevalence surveys.Antimicrobial resistance and infection control · 2024Pooled it
- Is routine antibiotic prophylaxis warranted in dental implant surgery to prevent early implant failure? - a systematic review.BMC oral health · 2024Pooled it
- Point prevalence of evidence-based antimicrobial use among hospitalized patients in sub-Saharan Africa: a systematic review and meta-analysis.Scientific reports · 2024Pooled it
- Cefiderocol for treating severe aerobic Gram-negative bacterial infections: technology evaluation to inform a novel subscription-style payment model.Health technology assessment (Winchester, England) · 2024Pooled it
- Assessment of global antimicrobial resistance campaigns conducted to improve public awareness and antimicrobial use behaviours: a rapid systematic review.BMC public health · 2024Pooled it
- One Health Determinants ofInternational journal of molecular sciences · 2023Pooled it
- The impact of antimicrobial de-escalation therapy in culture-negative pneumonia: a systematic review and meta-analysis.The Korean journal of internal medicine · 2023Pooled it
- A Systematic Review and Network Meta-analysis of Empirical Antibiotics for Complicated Urinary Tract Infections.Open forum infectious diseases · 2026Trial
- Bifidobacterium breve PRL2020 mitigates antibiotic-induced gut symptoms and dysbiosis in children treated with amoxicillin or amoxicillin-clavulanate.International microbiology : the official journal of the Spanish Society for Microbiology · 2026Trial
- Efficacy and Safety of Yinhua Miyanling Tablets for Uncomplicated Urinary Tract Infections: A Multicenter, Randomized, Double-Blind, Double-Dummy, Active-Controlled, Non-inferiority Clinical Trial.Chinese journal of integrative medicine · 2026Trial
- Implementing prescriber-pharmacist collaboration to improve evidence-based medication prescribing using asynchronous, non-interruptive electronic health record notifications.Implementation science : IS · 2025Trial
- Rapid molecular detection of respiratory pathogens in patients admitted with suspected community-acquired pneumonia: secondary analysis of a randomized controlled trial.Microbiology spectrum · 2025Trial
- Whole cranberry fruit powder supplement reduces the incidence of culture-confirmed urinary tract infections in females with a history of recurrent urinary tract infection: A 6-month multicenter, randomized, double-blind, placebo-controlled trial.The American journal of clinical nutrition · 2025Trial
- Assessment of Spillover of Antimicrobial Resistance to Untreated Children 7-12 Years Old After Mass Drug Administration of Azithromycin for Child Survival in Niger: A Secondary Analysis of the MORDOR Cluster-Randomized Trial.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024Trial
- Trial
- Pre-existing β-lactamase gene diversity is associated with lower risk of ESBL-producing Enterobacterales colonization in patients exposed to ceftriaxone.Gut microbes · 2026Article
- Impact of the COVID-19 pandemic on antibiotic treatment for respiratory tract infections in Norwegian primary care.Scandinavian journal of primary health care · 2026Article
- Reported Dosing-Related Medication Errors Involving Systemic Antibiotics in the Brazilian Pharmacovigilance Database (2018-2025): Distribution Across the WHO AWaRe Classification.Pharmacoepidemiology and drug safety · 2026Article
548 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundGreater use of antibiotics during the past 50 years has exerted selective pressure on susceptible bacteria and may have favoured the survival of resistant strains. Existing information on antibiotic resistance patterns from pathogens circulating among community-based patients is substantially less than from hospitalized patients on whom guidelines are often based. We therefore chose to assess the relationship between the antibiotic resistance pattern of bacteria circulating in the community and the consumption of antibiotics in the community.
methodsBoth gray literature and published scientific literature in English and other European languages was examined. Multiple regression analysis was used to analyse whether studies found a positive relationship between antibiotic consumption and resistance. A subsequent meta-analysis and meta-regression was conducted for studies for which a common effect size measure (odds ratio) could be calculated.
resultsElectronic searches identified 974 studies but only 243 studies were considered eligible for inclusion by the two independent reviewers who extracted the data. A binomial test revealed a positive relationship between antibiotic consumption and resistance (p < .001) but multiple regression modelling did not produce any significant predictors of study outcome. The meta-analysis generated a significant pooled odds ratio of 2.3 (95% confidence interval 2.2 to 2.5) with a meta-regression producing several significant predictors (F(10,77) = 5.82, p < .01). Countries in southern Europe produced a stronger link between consumption and resistance than other regions.
conclusionsUsing a large set of studies we found that antibiotic consumption is associated with the development of antibiotic resistance. A subsequent meta-analysis, with a subsample of the studies, generated several significant predictors. Countries in southern Europe produced a stronger link between consumption and resistance than other regions so efforts at reducing antibiotic consumption may need to be strengthened in this area. Increased consumption of antibiotics may not only produce greater resistance at the individual patient level but may also produce greater resistance at the community, country, and regional levels, which can harm individual patients.
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Identifiers
What OpenQuestion holds
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.