Evidence map›Paper›PMID 41023909›Full record

ArticleBMC infectious diseases2025

In search of pragmatic measures and models from routinely collected electronic records to inform continuous optimization of antibiotics stewardship at primary care settings: preliminary findings from Anhui, China.

Dongying Xiao, Xin Yang, Ying Zheng, Jia Xu, Ningjing Yang, Yin Li, Yuning Wang, Ruirui Cui, Nana Li, Rong Liu and 3 more

Abstract read
In one paragraph

Article in BMC infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. Review
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

13 authors.

Dongying Xiao *School of Health Service Management, Anhui Medical University, Hefei Anhui, 230032, China.ORCID http://orcid.org/0009-0008-5856-899X
Xin Yang *School of Health Service Management, Anhui Medical University, Hefei Anhui, 230032, China.ORCID http://orcid.org/0009-0002-6190-2588
Ying ZhengSchool of Health Service Management, Anhui Medical University, Hefei Anhui, 230032, China.ORCID http://orcid.org/0009-0009-1752-1105
Jia XuSchool of Health Service Management, Anhui Medical University, Hefei Anhui, 230032, China.ORCID http://orcid.org/0009-0000-9611-1482
Ningjing YangSchool of Health Service Management, Anhui Medical University, Hefei Anhui, 230032, China.ORCID http://orcid.org/0009-0002-7210-2842
Yin LiSchool of Health Service Management, Anhui Medical University, Hefei Anhui, 230032, China.ORCID http://orcid.org/0009-0009-3447-0880
Yuning WangSchool of Health Service Management, Anhui Medical University, Hefei Anhui, 230032, China.ORCID http://orcid.org/0009-0001-1556-3549
Ruirui CuiSchool of Health Service Management, Anhui Medical University, Hefei Anhui, 230032, China.ORCID http://orcid.org/0009-0005-6947-0048
Nana LiSchool of Health Service Management, Anhui Medical University, Hefei Anhui, 230032, China.ORCID http://orcid.org/0009-0009-0302-4060
Rong LiuSchool of Health Service Management, Anhui Medical University, Hefei Anhui, 230032, China.ORCID https://orcid.org/0000-0002-7968-5932
Manman LuSchool of Health Service Management, Anhui Medical University, Hefei Anhui, 230032, China.ORCID http://orcid.org/0000-0001-7517-6551
Debin WangSchool of Health Service Management, Anhui Medical University, Hefei Anhui, 230032, China. dbwang@vip.sina.com.ORCID http://orcid.org/0000-0002-5106-6427
Xingrong ShenSchool of Health Service Management, Anhui Medical University, Hefei Anhui, 230032, China. shenxr@ahmu.edu.cn.ORCID http://orcid.org/0000-0002-9708-9659

Funding

Anhui Province Primary Healthcare Service Evaluation Project K2021235National Natural Science Foundation of China 81861138049
6 · The paper itself

Abstract

backgroundAntimicrobial resistance caused by inappropriate antibiotic use has become a global public health crisis. The majority of antibiotics are prescribed at primary care settings which often lack sufficient capacity and surveillance. This study aimed at identifying and testing pragmatic measures and models derived from routinely collected electronic records of primary care encounters to inform continuous antibiotics stewardship.

methodsWe first extracted a total of 7.097 million records of primary care visits over 25 months from Anhui, China, through stratified random cluster sampling and a minimum set of data about related communities. We then identified pragmatic measures and models for examining antibiotic prescribing at primary care settings through repeated cycles of measure/model identification and relevance analysis. The 'identification' used multidisciplinary group meetings while the analysis adopted hybrid methodologies, including descriptive analysis, random forest classification modeling, and data visualization.

resultsThe study revealed that: (a) antibiotic prescribing rates ranged from 36.82 to 86.25% for the 7 categories of diagnoses studied, including respiratory diseases (RD), digestive diseases (DD), urogenital diseases (UD), skin infections (SI), injuries (IJ), eye infections (EI), and oral and dental diseases (OD); (b) although overall antibiotic prescribing decreased from 67.80 to 47.11% over the study period, the proportion of broad-spectrum added up to 78.96%; (c) the top 10% and 20% clinicians prescribed 59.9% and 80.0% of all the antibiotic prescriptions; (d) 50.8% of the antibiotic recipients received 2 or more antibiotic prescriptions within the 25-months; (e) the AUC of models of antibiotic prescribing ranged from 0.92 to 0.97 for the 7-category- diagnoses, in which the patient, clinician and spatiotemporal variables contributed 0.08 ~ 0.27, 0.30 ~ 0.70 and 0.16 ~ 0.62 respectively.

conclusionThe measures and models derived out of routinely collected electronic records of primary healthcare encounters in this study are both feasible and useful.

Indexed as

Anti-Bacterial AgentsAntimicrobial StewardshipElectronic Health RecordsPrimary Health CareAdultAgedChinaDrug PrescriptionsFemaleHumansMaleMiddle AgedAnti-Bacterial AgentsAntibiotic prescribingAntibiotics stewardshipChinaElectronic recordsPrimary care

Identifiers

PMID41023909
PMCPMC12482261

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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.