SynthesisThe Pediatric infectious disease journal2022
The Impact of Antimicrobial Stewardship in Children in Low- and Middle-income Countries: A Systematic Review.
Synthesis in The Pediatric infectious disease journal, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 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
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 27 citations in OpenAlex.
- 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 Resistance in Pediatric Infections: Current Status, Challenges, and Future Directions.Antibiotics (Basel, Switzerland) · 2026Review
- Multidrug-resistant organism carriage in Vietnamese district hospitals before and after an antimicrobial stewardship intervention.Antimicrobial resistance and infection control · 2026Article
- The impact of interventions to modify antibiotic use in children with suspected infections in ambulatory healthcare settings in LMICs: a systematic review.JAC-antimicrobial resistance · 2026Review
- Implementation of an antimicrobial stewardship program in Alexandria University Children's Hospital: an interventional study.Italian journal of pediatrics · 2026Article
- Outcome and management of 2-59-month-old Nigerian children with chest indrawing pneumonia at primary-level healthcare facilities: a prospective cohort study.Journal of global health · 2026Observational
- Impact of antimicrobial stewardship on healthcare-associated infections and antibiotic prescriptions in African countries: Systematic review and meta-analysis.Journal of infection prevention · 2026Review
- Antibiotic stewardship and point-of-care testing for children in 25 low-income and lower-middle-income countries: a systematic review and meta-analysis.EClinicalMedicine · 2025Article
- Age-Stratified Clinical and Microbiological Profiles in Pediatric Infectious Disease Admissions: Implications for Risk Prediction and Antimicrobial Stewardship.Pharmaceutics · 2025Article
- Barriers in implementing antibiotic stewardship programmes at paediatric units in academic hospitals in Thailand: a qualitative study.BMJ open · 2025Article
- Development and maintenance of consensus recommendations on pediatric outpatient antibiotic therapy in Germany: a framework for rational use.European journal of pediatrics · 2025Article
- Knowledge, Attitudes, Motivations, Expectations, and Systemic Factors Regarding Antimicrobial Use Amongst Community Members Seeking Care at the Primary Healthcare Level: A Scoping Review.Antibiotics (Basel, Switzerland) · 2025Review
- Antimicrobial Stewardship Program: actions and education in Brazilian pediatric intensive care units.Revista latino-americana de enfermagem · 2025Article
- Time is running out. No excuses to delay implementation of antimicrobial stewardship programmes: impact, sustainability, resilience and efficiency through an interrupted time series analysis (2017-2022).JAC-antimicrobial resistance · 2024Article
- Evaluation of Hospital Antimicrobial Stewardship Programs: Implementation, Process, Impact, and Outcomes, Review of Systematic Reviews.Antibiotics (Basel, Switzerland) · 2024Review
- Antibiotic and antifungal use in paediatric departments at three academic hospitals in South Africa.IJID regions · 2024Article
- An observational cohort study on the effects of extended postoperative antibiotic prophylaxis on surgical-site infections in low- and middle-income countries.The British journal of surgery · 2024Observational
- The impact of Antimicrobial Stewardship Programmes in paediatric emergency departments and primary care: a systematic review.Therapeutic advances in infectious diseaseReview
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 at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAntimicrobial stewardship (AMS) is central to the World Health Organisation Global Action Plan against antimicrobial resistance (AMR). If antibiotics are used without restraint, morbidity and mortality from AMR will continue to increase. In resource-rich settings, AMS can safely reduce antibiotic consumption. However, for children in low- and middle-income countries (LMIC), the impact of different AMS interventions is unknown.
aimTo determine the impact of different AMS interventions on antibiotic use and clinical and microbiologic outcomes in children in LMIC.
methodsMEDLINE, Embase and PubMed were searched for studies of AMS interventions in pediatric population in LMIC settings. Controlled trials, controlled before-and-after studies and interrupted time series studies were included. Outcomes assessed were antibiotic use, multidrug-resistant organism (MDRO) rates, clinical outcomes and cost.
resultsOf 1462 studies, 34 met inclusion criteria including a total population of >5,000,000 in 17 countries. Twenty were in inpatients, 2 in ED, 10 in OPD and 2 in both. Seven studies were randomized controlled trials. All types of interventions reported a positive impact on antibiotic prescribing. AMS bundles with education, and clinical decision tools appeared more effective than guidelines alone. AMS interventions resulted in significantly decreased clinical infections (4/4 studies) and clinical failure (2/2) and reduced MDRO colonization rate (4/4). There was no concomitant increase in mortality (4/4 studies) or length of stay (2/2).
conclusionMultiple effective strategies exist to reduce antibiotic consumption in LMIC. However, marked heterogeneity limit conclusions regarding the most effective approach, particularly regarding clinical outcomes. Overall, AMS strategies are important tools in the reduction of MDRO-related morbidity in children in LMIC.
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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.