ArticleBMJ open2019
Evaluating antibiotic stewardship in a tertiary care hospital in Kerala, India: a qualitative interview study.
Article in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 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
17 citing papers in PubMed, 2 syntheses or guidelines pooled it, 39 citations in OpenAlex.
- Health economic studies of antimicrobial stewardship programmes: A scoping review.NIHR open research · 2024Pooled 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
- Multilevel barriers to antimicrobial stewardship in tertiary care hospitals: A comparative systematic scoping review of high-income versus low-/middle-income countries evidence mapped by study design and healthcare professionals.Naunyn-Schmiedeberg's archives of pharmacology · 2026Article
- Perspectives and Challenges of Healthcare Professionals, Patients, and Caregivers Regarding Utilizing Antibiotics and Implementing Antibiotic Stewardship in Healthcare Facilities in Low- and Middle-Income Countries: A Systematic Review of Qualitative Studies.Antibiotics (Basel, Switzerland) · 2026Review
- A systematic review of the effectiveness and cost-effectiveness of implementing antimicrobial stewardship program at tertiary care facilities in India.IJID regions · 2025Article
- Antimicrobial stewardship programs in a Mexican private healthcare system: a self-assessment of core elements.BMC infectious diseases · 2024Article
- Barriers, facilitators, perceptions and impact of interventions in implementing antimicrobial stewardship programs in hospitals of low-middle and middle countries: a scoping review.Antimicrobial resistance and infection control · 2024Article
- Drivers of inappropriate use of antimicrobials in South Asia: A systematic review of qualitative literature.PLOS global public health · 2024Article
- RETRACTED: Empowering Low- and Middle-Income Countries to Combat AMR by Minimal Use of Antibiotics: A Way Forward.Antibiotics (Basel, Switzerland) · 2023Article
- Perceptions of effective policy interventions and strategies to address antibiotic misuse within primary healthcare in India: A qualitative study.Journal of infection prevention · 2023Article
- Hospital-based antimicrobial stewardship, India.Bulletin of the World Health Organization · 2023Article
- Determinants of clinician and patient to prescription of antimicrobials: Case of Mulanje, Southern Malawi.PLOS global public health · 2022Article
- Reversing the Trend of Antimicrobial Resistance in ICU: Role of Antimicrobial and Diagnostic Stewardship.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2021Article
- Mapping the Implementation of a Clinical Pharmacist-Driven Antimicrobial Stewardship Programme at a Tertiary Care Centre in South India.Antibiotics (Basel, Switzerland) · 2021Article
- Utilizing the SEIPS model to guide hand hygiene interventions at a tertiary hospital in Ethiopia.PloS one · 2021Article
- Article
- Antibiotic prescribing patterns and knowledge of antibiotic resistance amongst the doctors working at public health facilities of a state in northern India: A cross sectional study.Journal of family medicine and primary care · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 3 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo determine what barriers and facilitators to antibiotic stewardship exist within a healthcare facility.
setting1300-bed tertiary care private hospital located in the state of Kerala, India.
participants31 semistructured interviews and 4 focus groups with hospital staff ranging from physicians, nurses, pharmacists and a clinical microbiologist.
resultsKey facilitators of antibiotic stewardship (AS) at the hospital included a dedicated committee overseeing appropriate inpatient antibiotic use, a prompt microbiology laboratory, a high level of AS understanding among staff, established guidelines for empiric prescribing and an easily accessible antibiogram. We identified the following barriers: limited access to clinical pharmacists, physician immunity to change regarding stewardship policies, infrequent antibiotic de-escalation, high physician workload, an incomplete electronic medical record (EMR), inadequate AS programme (ASP) physical visibility and high antibiotic use in the community.
conclusionsOpportunities for improvement at this institution include increasing accessibility to clinical pharmacists, implementing strategies to overcome physician immunity to change and establishing a more accessible and complete EMR. Our findings are likely to be of use to institutions developing ASPs in lower resource settings.
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.