Trial reportNature medicine2026
Effects of a comprehensive antibiotic stewardship program on antibiotic prescribing for acute respiratory infections in rural facilities: a cluster randomized trial.
Trial report in Nature medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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.
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.
Who cites it
2 citing papers in PubMed.
- ADVANCE-ID bacterial and fungal infections review: antimicrobial resistance research updates: Summary of clinical trials and implementation studies, March-April 2026.JAC-antimicrobial resistance · 2026Article
- Making antibiotic stewardship guidelines work in real-world settings.Nature medicine · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors.
Funding
Abstract
Antimicrobial resistance is driven by inappropriate use of antibiotics for acute respiratory infections (ARIs), which is a major challenge in primary care in low- and middle-income countries. Here we conducted a pragmatic, cluster randomized controlled trial in 34 township hospitals in two rural counties of Guangdong, China, to evaluate whether a digitally enabled stewardship program could reduce antibiotic prescribing. The intervention combined training and guidelines for doctors; concise, evidence-based guidelines embedded in the electronic medical record with point-of-care prompts; monthly prescribing peer review feedback for doctors; and patient education delivered through a smartphone app. Control is usual care with no inputs. During the 12-month implementation period (1 March 2020 to 28 February 2021), we analyzed 97,239 eligible consultations for ARIs. The primary outcome was whether a consultation resulted in any antibiotics being prescribed. This outcome was met: antibiotics were prescribed in 26% (14,521/54,799) of intervention consultations compared to 71% (30,340/42,440) of control consultations, yielding an adjusted risk difference of -39 percentage points (95% confidence interval: -47 to -29; P < 0.001). There was no evidence of increased harm, as 30-day hospitalization rates for respiratory illness or sepsis did not differ between groups (adjusted risk difference, 0.2 percentage points; 95% confidence interval: -0.3 to 0.6). A comprehensive stewardship program can substantially reduce inappropriate antibiotic prescribing for ARIs in rural primary care facilities in China without compromising patient safety. Trial registration: ISRCTN96892547 .
Indexed as
Identifiers
41703293What OpenQuestion holds
Registered trials
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.