Evidence map›Paper›PMID 35338063›Full record

ArticleBMJ open2022

Identifying key influences on antibiotic use in China: a systematic scoping review and narrative synthesis.

Caroline Coope, Annegret Schneider, Tingting Zhang, Paul Kadetz, Rui Feng, Helen Lambert, DeBin Wang, Isabel Oliver, Susan Michie, Christie Cabral

Open access · goldAbstract readScoping Review
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
2.6field-weighted citation impact, top 6% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 27 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 5 institutions in 2 countries.

Caroline CoopePopulation Health Sciences, University of Bristol, Bristol, UK Caroline.Coope@bristol.ac.uk.ORCID 0000-0001-7803-8760
Annegret SchneiderPopulation Health Sciences, University of Bristol, Bristol, UK.
Tingting ZhangPopulation Health Sciences, University of Bristol Medical School, Bristol, UK.ORCID 0000-0002-2612-0014
Paul KadetzQueen Margaret University, Institute for Global Health and Development, Edinburgh, UK.
Rui FengLibrary, Anhui Medical University, Hefei, Anhui, China.
Helen LambertPopulation Health Sciences, University of Bristol, Bristol, UK.
DeBin WangSchool of Health Services Management, Anhui Medical University, Hefei, Anhui, China.ORCID 0000-0002-9708-9659
Isabel OliverField Service, National Infection Service, Public Health England National Infection Service, Salisbury, UK.
Susan MichieCentre for Behaviour Change, University College London, London, UK.
Christie CabralPopulation Health Sciences, University of Bristol, Bristol, UK.
University of Bristol · GBAnhui Medical University · CNPublic Health England · GBQueen Margaret University · GBUniversity College London · GB

Funding

Department of HealthMedical Research Council MR/P007546/1
6 · The paper itself

Abstract

introductionThe inappropriate use of antibiotics is a key driver of antimicrobial resistance. In China, antibiotic prescribing and consumption exceed recommended levels and are relatively high internationally. Understanding the influences on antibiotic use is essential to informing effective evidence-based interventions. We conducted a scoping review to obtain an overview of empirical research about key behavioural, cultural, economic and social influences on antibiotic use in China.

methodsSearches were conducted in Econlit, Medline, PsycINFO, Social Science citation index and the Cochrane Database of Systematic Reviews for the period 2003 to early 2018. All study types were eligible including observational and intervention, qualitative and quantitative designs based in community and clinical settings. Two authors independently screened studies for inclusion. A data extraction form was developed incorporating details on study design, behaviour related to antibiotic use, influences on behaviour and information on effect (intervention studies only).

resultsIntervention studies increased markedly from 2014, and largely focused on the impact of national policy and practice directives on antibiotic use in secondary and tertiary healthcare contexts in China. Most studies used pragmatic designs, such as before and after comparisons. Influences on antibiotic use clustered under four themes: antibiotic prescribing; adherence to antibiotics; self-medicating behaviour and over-the-counter sale of antibiotics. Many studies highlighted the use of antibiotics without a prescription for common infections, which was facilitated by availability of left-over medicines and procurement from local pharmacies.

conclusionsInterventions aimed at modifying antibiotic prescribing behaviour show evidence of positive impact, but further research using more robust research designs, such as randomised trials, and incorporating process evaluations is required to better assess outcomes. The effect of national policy at the primary healthcare level needs to be evaluated and further exploration of the influences on antibiotic self-medicating is required to develop interventions that tackle this behaviour.

Indexed as

Anti-Bacterial AgentsBacterial InfectionsChinaHumansAnti-Bacterial Agentshealth policyinternational health servicespublic health

Identifiers

PMID35338063
PMCPMC8961142
OpenAlexW4220931991

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.