SynthesisClinical infectious diseases : an official publication of the Infectious Diseases Society of America2025
Audit and Feedback Interventions for Antibiotic Prescribing in Primary Care: A Systematic Review and Meta-analysis.
Synthesis in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 2 of them syntheses that pooled it.
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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.
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Who cites it
31 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Digital patient safety interventions in primary care: a systematic review and meta-analysis.BMC medicine · 2026Pooled it
- Multifaceted and educational interventions to improve prescribing indicators in the Middle East and North Africa Region: a systematic review and meta-analysis.International journal of clinical pharmacy · 2026Pooled it
- Spillover From an Intervention on Antibiotic Prescribing for Family Physicians: A Post Hoc Secondary Analysis of a Randomized Clinical Trial.JAMA network open · 2025Trial
- General practitioners' perspectives on barriers and facilitators of the implementation of the ANTIBIORESIST antibiotic stewardship audit and feedback intervention: a qualitative interview study among high prescribers.JAC-antimicrobial resistance · 2026Article
- Who chooses to engage? Understanding the characteristics of physicians who voluntarily engage with an audit and feedback intervention: a retrospective cohort study.BMJ quality & safety · 2026Article
- From quality indicator to quality measurement: design and implementation of an automated audit and feedback tool for chronic kidney disease in Belgian primary care.BMJ health & care informatics · 2026Article
- Interventions to Reduce Antibiotic Prescribing in Small Animal Veterinary Practice: Evidence and Clinical Impact.Antibiotics (Basel, Switzerland) · 2026Review
- Residency Competency Assessments and Early-Career Primary Care Physicians' Antibiotic Prescribing.JAMA network open · 2026Article
- Diagnostic completeness: the missing link in antimicrobial stewardship in low- and middle-income countries.Journal of global health · 2026Article
- The Impact of Hospital-Based Fidaxomicin Use Criteria onInfectious disease reports · 2026Article
- Packaged intervention targeting oral antimicrobials in Japanese tertiary care outpatient setting: a quasi-experimental study.JAC-antimicrobial resistance · 2026Article
- Review
- Direct Oral Challenge for Penicillin Allergy: The International Network of Antibiotic Allergy Nations (iNAAN) Study.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Observational
- Review
- [Requirements for the rational use of antibiotics based on antibiotic stewardship].Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz · 2026Review
- Article
- Mailed Audit and Feedback for Antibiotic Prescribing in Primary Care.JAMA network open · 2026Article
- Practical and clinical significance of the pharmacist-led antimicrobial stewardship.Journal of pharmaceutical health care and sciences · 2026Review
- Benchmarking: A Tool for Veterinary Practices to Improve Prudent Use of Antibiotics in Cats and Dogs in Switzerland.Antibiotics (Basel, Switzerland) · 2026Article
- Trends in primary care antibiotic prescribing during the implementation of national stewardship policies: Türkiye, 2011-2019.Frontiers in microbiology · 2026Article
Corrections and comments
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Authors and funding
36 authors.
Funding
Abstract
backgroundThis systematic review evaluates the effect of audit and feedback (A&F) interventions targeting antibiotic prescribing in primary care and examines factors that may explain the variation in effectiveness.
methodsRandomized controlled trials (RCTs) involving A&F interventions targeting antibiotic prescribing in primary care were included in the systematic review. Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, and ClinicalTrials.gov were searched up to May 2024. Trial, participant, and intervention characteristics were extracted independently by 2 researchers. Random effects meta-analyses of trials that compared interventions with and without A&F were conducted for 4 outcomes: (1) total antibiotic prescribing volume; (2) unnecessary antibiotic initiation; (3) excessive prescription duration, and (4) broad-spectrum antibiotic selection. A stratified analysis was also performed based on study characteristics and A&F intervention design features for total antibiotic volume.
resultsA total of 56 RCTs fit the eligibility criteria and were included in the meta-analysis. A&F was associated with an 11% relative reduction in antibiotic prescribing volume (N = 21 studies, rate ratio [RR] = 0.89; 95% confidence interval [CI]: .84, .95; I2 = 97); 23% relative reduction in unnecessary antibiotic initiation (N = 16 studies, RR = 0.77; 95% CI: .68, .87; I2 = 72); 13% relative reduction in prolonged duration of antibiotic course (N = 4 studies, RR = 0.87 95% CI: .81, .94; I2 = 86); and 17% relative reduction in broad-spectrum antibiotic selection (N = 17 studies, RR = 0.83 95% CI: .75, .93; I2 = 96).
conclusionsA&F interventions reduce antibiotic prescribing in primary care. However, heterogeneity was substantial, outcome definitions were not standardized across the trials, and intervention fidelity was not consistently assessed. Clinical Trials Registration. Prospero (CRD42022298297).
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