Trial reportThe Journal of antimicrobial chemotherapy2018
Effects of primary care antimicrobial stewardship outreach on antibiotic use by general practice staff: pragmatic randomized controlled trial of the TARGET antibiotics workshop.
Trial report in The Journal of antimicrobial chemotherapy, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 4 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
44 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- A systematic review of national interventions and policies to optimize antibiotic use in healthcare settings in England.The Journal of antimicrobial chemotherapy · 2024Pooled it
- Pooled it
- Association Between Antimicrobial Stewardship Programs and Antibiotic Use Globally: A Systematic Review and Meta-Analysis.JAMA network open · 2023Pooled it
- Health Professions Digital Education on Antibiotic Management: Systematic Review and Meta-Analysis by the Digital Health Education Collaboration.Journal of medical Internet research · 2019Pooled it
- Self-reported acceptability and feasibility of a multimodal intervention to reduce antibiotic prescriptions for urinary tract infections in primary care: a process evaluation of the RedAres trial among general practitioners and medical practice assistants.BMC health services research · 2025Trial
- Trial
- Effect of a Feedback Visit and a Clinical Decision Support System Based on Antibiotic Prescription Audit in Primary Care: Multiarm Cluster-Randomized Controlled Trial.Journal of medical Internet research · 2024Trial
- Improving Outpatient Antibiotic Prescribing for Respiratory Tract Infections in Primary Care: A Stepped-Wedge Cluster Randomized Trial.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022Trial
- A pragmatic randomized trial of a primary care antimicrobial stewardship intervention in Ontario, Canada.BMC family practice · 2021Trial
- The Effectiveness of Small Group Education on Improving Antibiotic Prescribing in General Practice: A Mixed Methods Systematic Review.Antibiotics (Basel, Switzerland) · 2026Review
- A survey of parental health-seeking behaviour, knowledge, and expectations around ear infection symptoms in children.BJGP open · 2026Article
- A feasibility study of the use of a patient leaflet for respiratory tract infection consultations in general practice in Ireland.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2026Article
- Which interventions optimize antibiotic prescribing in primary care in England? A survey and Qualitative Comparative Analysis of NHS Integrated Care Boards.JAC-antimicrobial resistance · 2025Article
- Overview of Methods for Assessing Antimicrobial Use in Outpatient Settings in High-Income Countries: A Narrative Review.Antibiotics (Basel, Switzerland) · 2025Review
- Reducing antibiotic prescribing rates in young children in an outpatient primary care setting-a systemwide quality improvement initiative.JAC-antimicrobial resistance · 2025Article
- Implementation of a National Antimicrobial Stewardship Training Programme for General Practice: A Case Study.Antibiotics (Basel, Switzerland) · 2025Article
- Effectiveness of work-based educational interventions for antimicrobial stewardship: a systematic review.JAC-antimicrobial resistance · 2024Review
- A Study of Awareness, Knowledge, Attitudes, and Practices Regarding Antibiotic Resistance.Cureus · 2024Article
- Antibiotic Stewardship Interventions for Urinary Tract Infections in Outpatient Settings: A Narrative Review.Infectious disease clinics of North America · 2024Review
- Antibiotic Prescribing Patterns for Respiratory Tract Illnesses Following the Conclusion of an Education and Feedback Intervention in Primary Care.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024Article
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Objectives: To determine whether local trainer-led TARGET antibiotic interactive workshops improve antibiotic dispensing in general practice. Methods: Using a McNulty-Zelen-design randomized controlled trial within three regions of England, 152 general practices were stratified by clinical commissioning group, antibiotic dispensing rate and practice patient list size, then randomly allocated to intervention (offered TARGET workshop that incorporated a presentation, reflection on antibiotic data, promotion of patient and general practice (GP) staff resources, clinical scenarios and action planning, 73 practices) or control (usual practice, 79 practices). The primary outcome measure was total oral antibiotic items dispensed/1000 patients for the year after the workshop (or pseudo-workshop date for controls), adjusted for the previous year's dispensing. Results: Thirty-six (51%) intervention practices (166 GPs, 51 nurses and 101 other staff) accepted a TARGET workshop invitation. In the ITT analysis total antibiotic dispensing was 2.7% lower in intervention practices (95% CI -5.5% to 1%, P = 0.06) compared with controls. Dispensing in intervention practices was 4.4% lower for amoxicillin/ampicillin (95% CI 0.6%-8%, P = 0.02); 5.6% lower for trimethoprim (95% CI 0.7%-10.2%, P = 0.03); and a non-significant 7.1% higher for nitrofurantoin (95% CI -0.03 to 15%, P = 0.06). The Complier Average Causal Effect (CACE) analysis, which estimates impact in those that comply with assigned intervention, indicated 6.1% (95% CI 0.2%-11.7%, P = 0.04) lower total antibiotic dispensing in intervention practices and 11% (95% CI 1.6%-19.5%, P = 0.02) lower trimethoprim dispensing. Conclusions: This study within usual service provision found that TARGET antibiotic workshops can help improve antibiotic use, and therefore should be considered as part of any national antimicrobial stewardship initiatives. Additional local facilitation will be needed to encourage all general practices to participate.
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