ArticleBMJ open quality2018
Reducing inappropriate antibiotic prescribing in upper respiratory tract infection in a primary care setting in Kolkata, India.
Article in BMJ open quality, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 3 of them syntheses that pooled it.
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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.
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Who cites it
19 citing papers in PubMed, 3 syntheses or guidelines pooled it, 31 citations in OpenAlex.
- Academic Detailing Interventions and Evidence-Based Prescribing: A Systematic Review.JAMA network open · 2025Pooled it
- Barriers and facilitators of implementing interventions to improve appropriate antibiotic use in low- and middle-income countries: a systematic review based on the Consolidated Framework for Implementation Research.Implementation science : IS · 2022Pooled it
- Behavioural interventions to address rational use of antibiotics in outpatient settings of low-income and lower-middle-income countries.Tropical medicine & international health : TM & IH · 2021Pooled it
- Factors influencing antibiotic prescription for respiratory tract infections among prescribers in Jinja City, Uganda: a qualitative study.BMC pulmonary medicine · 2026Article
- Addressing Antimicrobial Resistance: A Point Prevalence Survey Using AWaRe Indicators from Outpatient Settings of Multan, Pakistan.Infection and drug resistance · 2026Article
- Article
- Behavioral Nudges to Encourage Appropriate Antimicrobial Use Among Health Professionals in Uganda.Antibiotics (Basel, Switzerland) · 2024Article
- Understanding antibiotic knowledge, attitudes, and practices: a cross-sectional study in physicians from a Colombian region, 2023.BMC medical education · 2024Article
- A Narrative Review of Recent Antibiotic Prescribing Practices in Ambulatory Care in Tanzania: Findings and Implications.Medicina (Kaunas, Lithuania) · 2023Review
- A Narrative Review of Antibiotic Prescribing Practices in Primary Care Settings in South Africa and Potential Ways Forward to Reduce Antimicrobial Resistance.Antibiotics (Basel, Switzerland) · 2023Article
- Antimicrobial Dispensing Practices during COVID-19 and the Implications for Pakistan.Antibiotics (Basel, Switzerland) · 2023Article
- 11-Year Trend in Antibiotic Consumption in a South-Eastern European Country; the Situation in Albania and the Implications for the Future.Antibiotics (Basel, Switzerland) · 2023Article
- Overuse of medications in low- and middle-income countries: a scoping review.Bulletin of the World Health Organization · 2023Article
- Determinants of the Empiric Use of Antibiotics by General Practitioners in South Africa: Observational, Analytic, Cross-Sectional Study.Antibiotics (Basel, Switzerland) · 2022Article
- Insertion of a Clinical Pathway Pop-Up Window into a Computer-Based Prescription System: A Method to Promote Antibiotic Stewardship in Upper Respiratory Tract Infection.Antibiotics (Basel, Switzerland) · 2021Article
- 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
- Article
- Article
- Using rubber stamps and mobile phones to help understand and change antibiotic prescribing behaviour in private sector primary healthcare clinics in Kenya.BMJ global health · 2019Article
Corrections and comments
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Authors and funding
1 author at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Inappropriate antibiotic use is a key factor in the emergence of antibiotic resistance. The majority of antibiotics are prescribed in primary care, where upper respiratory tract infection (URTI) is a common presentation. Inappropriate antibiotic prescribing in URTI is common globally and has increased markedly in developing and transitional countries. Antibiotic stewardship is crucial to prevent the emergence and spread of resistant microbes. This project aimed to reduce inappropriate antibiotic prescribing in URTI in a non-governmental organisation's primary care outreach clinics in Kolkata, India, from 62.6% to 30% over 4 months. A multifaceted intervention to reduce inappropriate antibiotic use in non-specific URTI was implemented. This consisted of a repeated process of audit and feedback, interactive training sessions, one-to-one case-based discussion, antibiotic guideline development and coding updates. The primary outcome measure was antibiotic prescribing rates. A baseline audit of all patients presenting with non-specific URTI over 8 weeks in November and December 2016 (n=222) found that 62.6% were prescribed antibiotics. Postintervention audit over 4 weeks in April 2017 (n=69) showed a marked reduction in antibiotic prescribing to 7.2%. An increase in documentation of examination findings was also observed, from 52.7% to 95.6%. This multifaceted intervention was successful at reducing inappropriate antibiotic prescribing, with sustained reductions demonstrated over the 4 months of the project. This suggests that approaches previously used in Europe can successfully be applied to different settings.
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