ArticleBMC infectious diseases2018
Antimicrobial use by WHO methodology at primary health care centers: a cross sectional study in Punjab, Pakistan.
Article in BMC infectious diseases, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 2 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
31 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Prevalence of antibiotics prescription amongst patients with and without COVID-19 in low- and middle-income countries: a systematic review and meta-analysis.Pathogens and global health · 2023Pooled it
- Antibiotic prescription practices in primary care in low- and middle-income countries: A systematic review and meta-analysis.PLoS medicine · 2020Pooled it
- Applying a gender and equity matrix for a contextualized antimicrobial stewardship intervention in Pakistan.Health policy and planning · 2026Article
- Contextual analysis of antibiotic prescribing practices for upper respiratory infections and diarrhoea in rural Punjab, Pakistan.Antimicrobial resistance and infection control · 2026Article
- Improving antibiotic prescribing in LMICs: Insights from an outpatient clinic in Pakistan.New microbes and new infections · 2026Article
- Antimicrobial resistance within the one health lens: global drivers, mechanisms and public health policy gaps in low resource settings.Frontiers in cellular and infection microbiology · 2026Review
- Evaluating Rational Drug Use in Developing Countries: A Cross-Sectional Analysis of Prescribing Patterns Against WHO Indicators in Pakistan and Yemen.Pharmacology research & perspectives · 2025Article
- Rational use of antibiotics at primary & secondary healthcare facilities in district Panchkula, Haryana, North India: A cross-sectional study.The Indian journal of medical research · 2025Article
- Patterns of Health Services and Medicine Utilisation by First-Generation Pakistani Immigrants in New Zealand.Health expectations : an international journal of public participation in health care and health policy · 2025Article
- Progress on the Global Research Agenda for Antimicrobial Resistance in Human Health in Pakistan: Findings and Implications.Infection and drug resistance · 2025Review
- Knowledge, attitudes, and practices regarding antimicrobial resistance and antimicrobial stewardship among healthcare workers in outpatient medical centers in Kenya: a qualitative study.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2025Article
- Examining the impact of treatment guidelines on outpatient antibiotic prescription trends at a cancer center in Pakistan.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2025Article
- Healthcare waste management and antimicrobial resistance: a critical review.Journal of water and health · 2024Review
- Estimation of country-specific tuberculosis resistance antibiograms using pathogen genomics and machine learning.BMJ global health · 2024Article
- Antimicrobial stewardship situation analysis in selected hospitals in Zambia: findings and implications from a national survey.Frontiers in public health · 2024Article
- Antimicrobial Use Among Hospitalized Neonates and Children; Findings and Implications from a Comprehensive Point Prevalence Survey Among General Tertiary Hospitals in Pakistan.Infection and drug resistance · 2024Article
- Evaluation of healthcare professionals' understanding of fluoroquinolones' safety profile, usage, and boxed warnings in Pakistan.Journal of pharmaceutical policy and practice · 2023Article
- Adherence to evidence-based implementation of antimicrobial treatment guidelines among prescribers in sub-Saharan Africa: a systematic review and meta-analysis.Journal of pharmaceutical policy and practice · 2023Review
- Antibiotic usage in a South African paediatric medical ward following the introduction of an antibiotic prescription chart.The Pan African medical journal · 2023Article
- Behavior-change interventions to improve antimicrobial stewardship in human health, animal health, and livestock agriculture: A systematic review.PLOS global public health · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTo investigate the antimicrobial (AM) use and prescribing patterns at primary health care centers (PHCCs) in Punjab, Pakistan.
methodsA cross-sectional study was designed according to the World Health Organization (WHO) methodology for AM usage from January, 2017 to June, 2017. Standard data collection forms designed by the WHO were used to collect the data from 32 PHCCs (16 rural healthcare centers (RHCs) and 16 basic health units (BHUs)) in Punjab province of Pakistan. PHCCs were randomly selected from 8 main cities. The study sample consisted of prescription records of 6400 outpatients (200 prescriptions records from each PHCC) and 800 inpatients (25 inpatient records from each PHCC). Data of the year 2016 were collected retrospectively by using systematic random sampling technique and analyzed through SPSS.
resultsAmong the hospital indicators, standard treatment guidelines (STGs) regarding the infectious diseases were not available in PHCCs. Number of days during which key AMs were out of stock was 12.1 days per month (range = 3.1-19.2). Out of total PHCC medicines costs, expenditures on AMs were 26.2% (range = 17.1-39.0). In case of prescribing indicators, the average number of AMs per prescription was 1.4 (range = 1.1-1.7), percentage of prescriptions prescribed with AMs was 81.5% (range = 68.9-89.1) and duration of AM treatment on average was 5.1 days per patient (range = 3.3-6.4). Average cost of prescribed AMs per patient was 1.3 USD (range = 0.6-4.3). The PHCCs prescribed a median of 5 (range = 3-9) types of AMs, including 10 (range = 5-15) individual agents. Out of 79.3% prescriptions of outpatients prescribed with AMs, only 16.4% were properly prescribed. Out of 100% prescriptions of inpatients prescribed with AMs, 12.1% were properly prescribed. Out of all the AM prescriptions 23.6% contained penicillins, 20.1% contained cephalosporins and 19.4% contained fluoroquinolones Metronidazole (18.0%), ciprofloxacin (16.5%) and co-amoxiclav (14.3%) were most commonly prescribed AMs.
conclusionsIn PHCCs, AMs were prescribed more frequently. However large proportions of these prescriptions were inappropriate. Continuous education and training of medical staff and cost effective policies could play an important role in promotion of rational use of AMs.
Indexed as
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.