ArticlePloS one2014
The impact of policy guidelines on hospital antibiotic use over a decade: a segmented time series analysis.
Article in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 3 of them syntheses that pooled it.
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Who cites it
24 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Printed educational materials: effects on professional practice and healthcare outcomes.The Cochrane database of systematic reviews · 2020Pooled it
- Antibiotic stewardship interventions in hospitals in low-and middle-income countries: a systematic review.Bulletin of the World Health Organization · 2018Pooled it
- Interventions to improve antibiotic prescribing practices for hospital inpatients.The Cochrane database of systematic reviews · 2017Pooled it
- Quality improvement initiative improves the empiric antibiotic prescribing practices in a tertiary care children's hospital in India.BMJ open quality · 2023Trial
- Web-Based Just-in-Time Information and Feedback on Antibiotic Use for Village Doctors in Rural Anhui, China: Randomized Controlled Trial.Journal of medical Internet research · 2018Trial
- Reducing inappropriate antibiotic prescribing behaviour among dental practitioners in a south Indian City through an educational intervention- a mixed methods feasibility study.BMC public health · 2026Article
- Review
- Health-system drivers of outpatient antibiotic use: evidence from prescribing, centralized supply, and catchment populations in public tertiary hospitals in Bihar, India.Frontiers in health services · 2026Article
- Impact of a tailored, department-specific antimicrobial stewardship team intervention based on AWaRe guidelines: a single-center, cohort, interrupted-time series study.Journal of pharmaceutical health care and sciences · 2025Article
- Pharmaceutical expenditure changes under the volume-based procurement policy: Effects and influencing factors.PloS one · 2025Article
- Article
- Article
- Factors influencing dairy cattle farmer use of antimicrobials on farms in New South Wales, Australia.Australian veterinary journal · 2022Article
- Antimicrobial Prescribing Confidence and Knowledge Regarding Drug Resistance: Perception of Medical Students in Malaysia and the Implications.Antibiotics (Basel, Switzerland) · 2022Article
- Antibiotic Use in China's Public Healthcare Institutions During the COVID-19 Pandemic: An Analysis of Nationwide Procurement Data, 2018-2020.Frontiers in pharmacology · 2022Article
- Strategies Used for Implementing and Promoting Adherence to Antibiotic Guidelines in Low- and Lower-Middle-Income Countries: A Systematic Review.Tropical medicine and infectious disease · 2021Review
- Paediatric Common Infections Pathways: improving antimicrobial stewardship and promoting ambulation for children presenting with common infections to hospitals in the UK and Ireland.JAC-antimicrobial resistance · 2021Article
- Observational
- Effects of restrictive-prescribing stewardship on antibiotic consumption in primary care in China: an interrupted time series analysis, 2012-2017.Antimicrobial resistance and infection control · 2020Article
- A behavioural approach to specifying interventions: what insights can be gained for the reporting and implementation of interventions to reduce antibiotic use in hospitals?The Journal of antimicrobial chemotherapy · 2020Article
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionAntibiotic pressure contributes to rising antibiotic resistance. Policy guidelines encourage rational prescribing behavior, but effectiveness in containing antibiotic use needs further assessment. This study therefore assessed the patterns of antibiotic use over a decade and analyzed the impact of different modes of guideline development and dissemination on inpatient antibiotic use.
methodsAntibiotic use was calculated monthly as defined daily doses (DDD) per 100 bed days for nine antibiotic groups and overall. This time series compared trends in antibiotic use in five adjacent time periods identified as 'Segments,' divided based on differing modes of guideline development and implementation: Segment 1--Baseline prior to antibiotic guidelines development; Segment 2--During preparation of guidelines and booklet dissemination; Segment 3--Dormant period with no guidelines dissemination; Segment 4--Booklet dissemination of revised guidelines; Segment 5--Booklet dissemination of revised guidelines with intranet access. Regression analysis adapted for segmented time series and adjusted for seasonality assessed changes in antibiotic use trend.
resultsOverall antibiotic use increased at a monthly rate of 0.95 (SE = 0.18), 0.21 (SE = 0.08) and 0.31 (SE = 0.06) for Segments 1, 2 and 3, stabilized in Segment 4 (0.05; SE = 0.10) and declined in Segment 5 (-0.37; SE = 0.11). Segments 1, 2 and 4 exhibited seasonal fluctuations. Pairwise segmented regression adjusted for seasonality revealed a significant drop in monthly antibiotic use of 0.401 (SE = 0.089; p<0.001) for Segment 5 compared to Segment 4. Most antibiotic groups showed similar trends to overall use.
conclusionUse of overall and specific antibiotic groups showed varied patterns and seasonal fluctuations. Containment of rising overall antibiotic use was possible during periods of active guideline dissemination. Wider access through intranet facilitated significant decline in use. Stakeholders and policy makers are urged to develop guidelines, ensure active dissemination and enable accessibility through computer networks to contain antibiotic use and decrease antibiotic pressure.
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