SynthesisThe Journal of antimicrobial chemotherapy2018
Variation in antibiotic use among and within different settings: a systematic review.
Synthesis 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, 5 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, 5 syntheses or guidelines pooled it, 66 citations in OpenAlex.
- Epidemiology of ophthalmia neonatorum: a systematic review and meta-analysis.BMC pediatrics · 2025Pooled it
- The impact of antimicrobial stewardship interventions on appropriate use of surgical antimicrobial prophylaxis in low- and middle-income countries: a systematic review.Systematic reviews · 2024Pooled it
- Antibiotic use in Brazilian hospitals in the 21st century: a systematic review.Revista da Sociedade Brasileira de Medicina Tropical · 2021Pooled it
- Quality indicators assessing antibiotic use in the outpatient setting: a systematic review followed by an international multidisciplinary consensus procedure.The Journal of antimicrobial chemotherapy · 2018Pooled it
- Metrics for quantifying antibiotic use in the hospital setting: results from a systematic review and international multidisciplinary consensus procedure.The Journal of antimicrobial chemotherapy · 2018Pooled it
- Eliminating Inappropriate Postoperative Antibiotics: A Stepped-Wedge Cluster Randomized Trial.Pediatrics · 2026Trial
- Knowledge, Attitudes, and Practices of Antibiotic Prescribing Among Arab Dental Students: A Cross-Sectional Study.International dental journal · 2026Article
- Inappropriate antibiotic utilization in hospitalized patients in Ethiopia: A systematic review and meta-analysis.Exploratory research in clinical and social pharmacy · 2026Review
- How Health Policies Shape Antibiotic Use: A Nationwide Study of "Access"-Group Antibiotics Availability and Consumption in a Middle-Income Country: The Case of Kazakhstan.Antibiotics (Basel, Switzerland) · 2026Article
- Antibiotic Prescribing for Cellulitis in the Absence of Penicillin-Cephalosporin Cross-Reactivity Alerts: A Retrospective Study.Pharmacology research & perspectives · 2025Article
- The prevalence of and variation in indicators of the quality and safety of long term aged care in Australia, 2019: a cross-sectional population-based study.The Medical journal of Australia · 2025Article
- Impact of the COVID-19 Pandemic on Hospital Antimicrobial Purchasing in Canada (2018-2021): An Exploratory Analysis.Journal of the Association of Medical Microbiology and Infectious Disease Canada = Journal officiel de l'Association pour la microbiologie medicale et l'infectiologie Canada · 2025Article
- Antibiotic use at the Centre Hospitalier Universitaire de Zone d'Abomey Calavi/Sô-Ava (CHUZ/AS) in Benin: a point prevalence survey.JAC-antimicrobial resistance · 2025Article
- Drug resistance and genotyping studies ofFrontiers in veterinary science · 2025Article
- The Role of the Skin Microbiome in Acne: Challenges and Future Therapeutic Opportunities.International journal of molecular sciences · 2024Review
- Review of the national usage of antibiotics in arthroplasty surgery: a need for evidence-based prescribing.Annals of the Royal College of Surgeons of England · 2024Article
- Excellence in Antibiotic Stewardship: A Mixed-Methods Study Comparing High-, Medium-, and Low-Performing Hospitals.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024Article
- Antimicrobial stewardship: a definition with a One Health perspective.npj antimicrobials and resistance · 2024Review
- Evaluation of Hospital Antimicrobial Stewardship Programs: Implementation, Process, Impact, and Outcomes, Review of Systematic Reviews.Antibiotics (Basel, Switzerland) · 2024Review
- Hospital antimicrobial stewardship funding and resourcing impact on broad-spectrum antibiotic use: a cross-sectional study.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
14 authors at 5 institutions in 5 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Objectives: Variation in antibiotic use may reflect inappropriate use. We aimed to systematically describe the variation in measures for antibiotic use among settings or providers. This study was conducted as part of the innovative medicines initiative (IMI)-funded international project DRIVE-AB. Methods: We searched for studies published in MEDLINE from January 2004 to January 2015 reporting variation in measures for systemic antibiotic use (e.g. DDDs) in inpatient and outpatient settings. The ratio between a study's reported maximum and minimum values of a given measure [maximum:minimum ratio (MMR)] was calculated as a measure of variation. Similar measures were grouped into categories and when possible the overall median ratio and IQR were calculated. Results: One hundred and forty-three studies were included, of which 85 (59.4%) were conducted in Europe and 12 (8.4%) in low- to middle-income countries. Most studies described the variation in the quantity of antibiotic use in the inpatient setting (81/143, 56.6%), especially among hospitals (41/81, 50.6%). The most frequent measure was DDDs with different denominators, reported in 23/81 (28.4%) inpatient studies and in 28/62 (45.2%) outpatient studies. For this measure, we found a median MMR of 3.7 (IQR 2.6-5.0) in 4 studies reporting antibiotic use in ICUs in DDDs/1000 patient-days and a median MMR of 2.3 (IQR 1.5-3.2) in 18 studies reporting outpatient antibiotic use in DDDs/1000 inhabitant-days. Substantial variation was also identified in other measures. Conclusions: Our review confirms the large variation in antibiotic use even across similar settings and providers. Data from low- and middle-income countries are under-represented. Further studies should try to better elucidate reasons for the observed variation to facilitate interventions that reduce unwarranted practice variation. In addition, the heterogeneity of reported measures clearly shows that there is need for standardization.
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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.