Evidence map›Paper›PMID 35509517›Full record

ReviewThe Canadian journal of infectious diseases & medical microbiology = Journal canadien des maladies infectieuses et de la microbiologie medicale2022

In-Hospital Macro-, Meso-, and Micro-Drivers and Interventions for Antibiotic Use and Resistance: A Rapid Evidence Synthesis of Data from Canada and Other OECD Countries.

Rosa Stalteri Mastrangelo, Anisa Hajizadeh, Thomas Piggott, Mark Loeb, Michael Wilson, Luis Enrique Colunga Lozano, Yetiani Roldan, Hussein El-Khechen, Anna Miroshnychenko, Priya Thomas and 2 more

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In one paragraph

Review in The Canadian journal of infectious diseases & medical microbiology = Journal canadien des maladies infectieuses et de la microbiologie medicale, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

12 authors.

Rosa Stalteri Mastrangelo *Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.ORCID https://orcid.org/0000-0002-0566-3394
Anisa Hajizadeh *Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
Thomas PiggottDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
Mark LoebDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
Michael WilsonDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
Luis Enrique Colunga LozanoDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.ORCID https://orcid.org/0000-0001-7737-4914
Yetiani RoldanDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
Hussein El-KhechenDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
Anna MiroshnychenkoDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
Priya ThomasDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
Holger J SchünemannDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
Robby NieuwlaatDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Hospitals continue to face challenges in reducing incorrect antibiotic use due to social and cultural factors at the level of the health system, the care facility, the provider, and the patient. The objective of this paper is to highlight the social and cultural drivers of antimicrobial use and resistance and targeted interventions for secondary and tertiary care settings in Canada and other OECD countries. This paper is an extension of the synthesis conducted for the Public Health Agency of Canada's 2019 Spotlight Report: Preserving Antibiotics Now and Into the Future. We conducted a systematic review with a few modifications to meet rapid timelines. We conducted a search in Ovid MEDLINE and McMaster University's evidence databases for systematic reviews and then for individual Canadian studies. To cast a wider net, we searched OECD organization websites and screened reference lists from systematic reviews. We synthesized the evidence narratively and categorized the evidence into macro-, meso-, and microlevel. A total of 70 studies were (a) from OCED countries and summarized evidence of potential sociocultural antimicrobial resistance and use barriers or facilitators and/or interventions addressing these challenges; (b) systematic reviews with 50% of included studies that are situated in secondary and tertiary settings; and (c) published in Canada's two official languages, English and French. We found that hospital structures and policies may influence antibiotic utilization and variations in antimicrobial management. Microlevel factors may sway inappropriate prescribing among clinicians. The amount and type of antibiotics used may affect resistance rates. Interventions were mainly comprised of antibiotic stewardship and training that modify clinician behavior and that educate patients and carers. This evidence synthesis illustrates the various drivers of, and interventions for, antimicrobial use and resistance at the macro-, meso-, and microlevel in secondary and tertiary settings. We demonstrate that upstream drivers may lead to downstream events that influence antimicrobial resistance.

Identifiers

PMID35509517
PMCPMC9061047

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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.