SynthesisSystematic reviews2024
Antimicrobial prescription pattern and appropriateness for respiratory tract infection in outpatients: a systematic review and meta-analysis.
Synthesis in Systematic reviews, 2024. 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.
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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.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Antibiotics Use Patterns in Low- and Middle-Income Countries: A Systematic Review Analysis.Inquiry : a journal of medical care organization, provision and financingPooled it
- Interventions to Reduce Antibiotic Prescribing in Small Animal Veterinary Practice: Evidence and Clinical Impact.Antibiotics (Basel, Switzerland) · 2026Review
- Implementation of C-Reactive Protein Point-of-Care Testing for Respiratory Tract Infections in Primary Care: A Systematic Review Using the RE-AIM Framework.Antibiotics (Basel, Switzerland) · 2026Review
- Identifying Distinct Antibiotic Behavioural Profiles in Singapore's General Population: A Latent Class Analysis.Antibiotics (Basel, Switzerland) · 2026Article
- Oral antibiotic exposure and urinary tract infection risk in adults: a self-controlled case series study.EClinicalMedicine · 2026Article
- Impact of appropriate antimicrobial therapy on patient outcomes and antimicrobial use: a sub analysis of the DIANA Study Dataset.Intensive care medicine · 2026Article
- Barriers and facilitators to implementing antimicrobial stewardship (AMS) in a Chinese tertiary hospital: a qualitative study based on the Consolidated Framework for Implementation Research (CFIR).BMC infectious diseases · 2026Article
- Antibiotic treatment for acute sinusitis and subsequent health care use and work absence: a nationwide registry study from Norway.Family practice · 2026Observational
- Improving antibiotic prescribing in LMICs: Insights from an outpatient clinic in Pakistan.New microbes and new infections · 2026Article
- Beta-lactam antibiotics under light: optical and photochemical characterization.Photochemical & photobiological sciences : Official journal of the European Photochemistry Association and the European Society for Photobiology · 2026Article
- Population structure reveals clade- and region-specific dissemination of macrolide-resistantFrontiers in cellular and infection microbiology · 2026Article
- Antibiotic prescribing for outpatients with respiratory tract infections in public and private clinics of a resource-constrained setting, northern Ethiopia: a cross-sectional study.BMC infectious diseases · 2025Article
- Determinants of Implementation of Antimicrobial Stewardship Interventions for Managing Community Adult Acute Respiratory Infections: Qualitative Analysis from the OPTIMAS-GP Study Co-Design Phase.Antibiotics (Basel, Switzerland) · 2025Article
- Pattern and appropriateness of antibiotic therapy for acute respiratory tract infection among under-five children accessing care in a tertiary facility, Sokoto, Nigeria.BMJ paediatrics open · 2025Article
- Prescription of EPs 7630 is associated with short- and long-term benefits in acute bronchitis: a real-world data analysis.Frontiers in pharmacology · 2025Article
- Impact of Education on Inappropriate Antibiotic Prescription for Respiratory Tract Infection Based on Physicians' Justifications: A Web-Based Survey in Japan.Antibiotics (Basel, Switzerland) · 2024Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMillions of people die every year as a result of antimicrobial resistance worldwide. An inappropriate prescription of antimicrobials (e.g., overuse, inadequate use, or a choice that diverges from established guidelines) can lead to a heightened risk of antimicrobial resistance. This study aimed to determine the rate and appropriateness of antimicrobial prescriptions for respiratory tract infections.
methodsThis review was conducted in accordance with the PRISMA guidelines. Web of Science, PubMed, ProQuest Health and Medicine, and Scopus were searched between October 1, 2023, and December 15, 2023, with no time constraints. Studies were independently screened by the first author and the co-authors. We included original studies reporting antimicrobial prescription patterns and appropriateness for respiratory tract infections. The quality of included studies' was assessed via the Joanna Briggs Institute's Critical Appraisal Checklists for Cross-Sectional Studies. The assessment of publication bias was conducted using a funnel plot and Egger's regression test. A random effect model was employed to estimate the pooled antibiotic prescribing and inappropriate rates. Subgroup analysis was conducted by country, study period, data source, and age group.
resultsOf the total 1220 identified studies, 36 studies were included in the review. The antimicrobial prescribing rate ranged from 25% (95% CI 0.24-0.26) to 90% (95% CI 0.89-0.91). The pooled antimicrobial prescription rate was 66% (95% CI 0.57 to 0.73). Subgroup analysis by region revealed that the antimicrobial prescription rate was highest in Africa (79%, 95% CI 0.48-0.94) and lowest in Europe (47%, 95% CI 0.32-0.62). Amoxicillin and amoxicillin-clavulanate antimicrobials from the Access group, along with azithromycin and erythromycin from the Watch group, were the most frequently used antimicrobial agents. This study revealed that the major reasons for antimicrobial prescription were acute bronchitis, pharyngitis, sinusitis, and the common cold. The pooled inappropriate antimicrobial prescription rate was 45% (95% CI 0.38-0.52). Twenty-eight of the included studies reported that prescribing antimicrobials without proper indications was the main cause of inappropriate antimicrobial prescriptions. Additionally, subgroup analysis by region showed a higher inappropriate antimicrobial prescription rate in Asia at 49% (95% CI 0.38-0.60). The result of the funnel plot and Egger's tests revealed no substantial publication bias (Egger's test: p = 0.268).
conclusionThe prescribing rate and inappropriate use of antimicrobials remain high and vary among countries. Further studies should be conducted to generate information about factors contributing to unnecessary antimicrobial prescriptions in outpatients. SYSTEMATIC REVIEW REGISTRATION: Systematic review registration: CRD42023468353.
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