Trial reportBMJ open quality2019
Reducing inappropriate outpatient antibiotic prescribing: normative comparison using unblinded provider reports.
Trial report in BMJ open quality, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 3 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
37 citing papers in PubMed, 3 syntheses or guidelines pooled it, 60 citations in OpenAlex.
- Strategies and outcomes of CDSS implementation for antimicrobial stewardship in hospital settings: a systematic review.Antimicrobial resistance and infection control · 2026Pooled it
- Pooled it
- Pooled it
- Promoting long-acting reversible contraception among post-abortion clients with a provider-comparison intervention: a cluster randomized controlled trial in Nepal.BMC public health · 2024Trial
- Cost to implement an outpatient stewardship intervention for acute otitis media (AOM).Antimicrobial stewardship & healthcare epidemiology : ASHE · 2026Article
- Uncharted territory: assessing antibiotic adverse drug events from walk-in clinics at an academic healthcare system.Antimicrobial stewardship & healthcare epidemiology : ASHE · 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
- The role of the community pharmacist in antibiotic use - a commentary on current status and future perspectives.Exploratory research in clinical and social pharmacy · 2025Article
- Microalgae, Cell Factories for Antimicrobial Peptides: A Promising Response to Antibiotic Resistance.Antibiotics (Basel, Switzerland) · 2025Review
- Proteomic Insights into Bacterial Responses to Antibiotics: A Narrative Review.International journal of molecular sciences · 2025Review
- Monitoring of Antibiotic Resistance Patterns Within Al-Karak Governmental Hospital, Jordan, in 2022.Antibiotics (Basel, Switzerland) · 2024Article
- Antibiotic Prescribing Decisions for Upper Respiratory Tract Infections Among Primary Healthcare Physicians in China: A Mixed-Methods Approach Based on the Theory of Planned Behavior.Antibiotics (Basel, Switzerland) · 2024Article
- Healthcare waste management and antimicrobial resistance: a critical review.Journal of water and health · 2024Review
- Influencing Primary Care Antibiotic Prescription Behavior Using Financial Incentives.Production and operations management · 2024Article
- Quality improvement initiative to reduce URI-associated antibiotic prescriptions among adult primary care providers.BMJ open quality · 2024Article
- Designing Communication Feedback Systems To Reduce Healthcare Providers' Implicit Biases In Patient Encounters.Proceedings of the SIGCHI conference on human factors in computing systems. CHI Conference · 2024Article
- Impact of a quality improvement programme on the preparation and administration of medications via a nasoenteral feeding tube: 2014-2019 intervention study.BMJ open quality · 2023Article
- Simple optical nanomotion method for single-bacterium viability and antibiotic response testing.Proceedings of the National Academy of Sciences of the United States of America · 2023Article
- Risk Factors for Bloodstream Infections Due to ESBL-ProducingPharmacy (Basel, Switzerland) · 2023Article
- COVID-19 and Outpatient Antibiotic Prescriptions in the United States: A County-Level Analysis.Open forum infectious diseases · 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
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Importance: Antibiotic resistance is a global health issue. Up to 50% of antibiotics are inappropriately prescribed, the majority of which are for acute respiratory tract infections (ARTI). Objective: To evaluate the impact of unblinded normative comparison on rates of inappropriate antibiotic prescribing for ARTI. Design: Non-randomised, controlled interventional trial over 1 year followed by an open intervention in the second year. Setting: Primary care providers in a large regional healthcare system. Participants: The test group consisted of 30 primary care providers in one geographical region; controls consisted of 162 primary care providers located in four other geographical regions. Intervention: The intervention consisted of provider and patient education and provider feedback via biweekly, unblinded normative comparison highlighting inappropriate antibiotic prescribing for ARTI. The intervention was applied to both groups during the second year. Main outcomes and measures: Rate of inappropriate antibiotic prescription for ARTI. Results: Baseline inappropriate antibiotic prescribing for ARTI was 60%. After 1 year, the test group rate of inappropriate antibiotic prescribing decreased 40%, from 51.9% to 31.0% (p<0.0001), whereas controls decreased 7% (61.3% to 57.0%, p<0.0001). In year 2, the test group decreased an additional 47% to an overall prescribing rate of 16.3%, and the control group decreased 40% to a prescribing rate of 34.5% after implementation of the same intervention. Conclusions and relevance: Provider and patient education followed by regular feedback to provider via normative comparison to their local peers through unblinded provider reports, lead to reductions in the rate of inappropriate antibiotic prescribing for ARTI and overall antibiotic prescribing rates.
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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.