ReviewTropical medicine and infectious disease2021
Strategies Used for Implementing and Promoting Adherence to Antibiotic Guidelines in Low- and Lower-Middle-Income Countries: A Systematic Review.
Review in Tropical medicine and infectious disease, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis 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
16 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Protocols, policies and practices for antimicrobial stewardship in hospitalized patients in least-developed and low-income countries: a systematic review.Antimicrobial resistance and infection control · 2023Pooled it
- Antimicrobial stewardship in low- and middle-income countries: Access versus adherence.PLoS medicine · 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
- Article
- Antimicrobial stewardship programs in primary and secondary care settings in India: current challenges, facilitators, perceptions, and impact - a scoping review.BMC infectious diseases · 2025Article
- A strategic approach to regulating new antimicrobials.Journal of global health · 2025Article
- Antibiotic Use in Pediatric Care in Ghana: A Call to Action for Stewardship in This Population.Antibiotics (Basel, Switzerland) · 2025Article
- Global variation in antibiotic prescribing guidelines and the implications for decreasing AMR in the future.Frontiers in pharmacology · 2025Review
- A complex intervention to reduce antibiotic prescribing in rural China: a cluster randomised controlled trial.The Lancet regional health. Western Pacific · 2024Article
- Challenges in Diagnosing and Treating Acutely Febrile Children with Suspected Malaria at Health Care Facilities in the Lake Mwanza Region of Tanzania.The American journal of tropical medicine and hygiene · 2024Article
- 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
- Point Prevalence Survey of Antimicrobial Use during the COVID-19 Pandemic among Different Hospitals in Pakistan: Findings and Implications.Antibiotics (Basel, Switzerland) · 2022Article
- Ongoing Efforts to Improve Antimicrobial Utilization in Hospitals among African Countries and Implications for the Future.Antibiotics (Basel, Switzerland) · 2022Article
- Determinants of the Empiric Use of Antibiotics by General Practitioners in South Africa: Observational, Analytic, Cross-Sectional Study.Antibiotics (Basel, Switzerland) · 2022Article
- Pattern of Antimicrobial Susceptibility and Antimicrobial Treatment of Neonates Admitted with Suspected Sepsis in a Teaching Hospital in Ghana, 2021.International journal of environmental research and public health · 2022Article
- An opportunity for global antimicrobial stewardship research: Refugee populations.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2022Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
Abstract
Containing antimicrobial resistance and reducing high levels of antibiotic consumption in low- and lower middle-income countries are a major challenge. Clinical guidelines targeting antibiotic prescribing can reduce consumption, however, the degrees to which clinical guidelines are adopted and adhered to are challenging for developers, policy makers and users. The aim of this study was to review the strategies used for implementing and promoting antibiotic guideline adherence in low- and lower middle-income countries. A review of published literature was conducted using PubMed, Cochrane Library, SCOPUS and the information systems of the World Health Organization and the Australian National University according to PRISMA guidelines and our PROSPERO protocol. The strategies were grouped into five broad categories based on the Cochrane Effective Practice and Organization of Care taxonomy. The 33 selected studies, representing 16 countries varied widely in design, setting, disease focus, methods, intervention components, outcomes and effects. The majority of interventions were multifaceted and resulted in a positive direction of effect. The nature of the interventions and study variability made it impossible to tease out which strategies had the greatest impact on improving CG compliance. Audit and feedback coupled with either workshops and/or focus group discussions were the most frequently used intervention components. All the reported strategies are established practices used in antimicrobial stewardship programs in high-income countries. We recommend interrupted time series studies be used as an alternative design to pre- and post-intervention studies, information about the clinical guidelines be made more transparent, and prescriber confidence be investigated.
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