Effects of interventions targeting clinicians and parents to reduce antibiotic prescribing for respiratory tract infections in children
| Study | Age | Outcome | Intervention | Control | OR [95% CI] or % difference | NNT | Mean difference | Significance | Risk of bias |
|---|---|---|---|---|---|---|---|---|---|
| Cohen15 2000 | <10 yr | Proportion receiving ABx | 523/1957 (26.7%) | 670/1807 (37.1%) | 0.62 [0.54 to 0.75] | 10 | – | <0.001 | Moderate |
| Doyne16 2004a,b | NR | ABx filled/consultation | 0.82 (0.71–0.95) | 0.86 (0.77–0.95) | 0.04 | – | – | NS | High |
| Finkelstein17 2001a,b | 3 to <36 mo | Change in ABx/person–year | −18.6% | −11.5% | 7.1% | – | – | <0.001 | Moderate |
| 36 to <72 mo | −15% | −9.8% | 5.2% | – | – | <0.001 | |||
| Francis18 2006c | NR | Exceptions to care pathway | 33.7% | 41.2% | 7.5% | 13 | <0.001 | Moderate | |
| Francis19 2009a | 6 mo–14 yr | ABx/index consultation | 50/256 (19.5%) | 111/272 (40.8%) | 0.35 [0.23 to 0.53] | 5 | – | <0.001 | Minimum |
| Juzych20 2005b,d | NR | Change in ABx/consultation | −25.9% | −4.8% | 21.1% | – | – | I: <0.0001e C: 0.35e | Moderate |
| Mainous21 2000b | <18 yr | Mean change in proportion of consultations resulting in ABx | 15.3% | 22.5% | – | – | 7.2% | <0.05 | Moderate |
| Regev-Yochay22 2011a | <18 yr | ABx/100 patient–years (n) | Moderate | ||||||
| Year 0, baseline | 78.38 (43 677) | 76.32 (44 453) | 1.116 [0.91 to 1.36] | – | – | – | |||
| Year 1, baseline | 65.57 (44 702) | 70.95 (45 195) | 0.914 [0.89 to 0.93] | – | – | – | |||
| Year 2, intervention | 46.93 (42 495) | 59.34 (45 918) | 0.765 [0.75 to 0.78] | – | – | – | |||
| Year 3, intervention | 48.18 (46 046) | 57.58 (48 023) | 0.809 [0.79 to 0.83] | – | – | – | |||
| Year 4, intervention | 48.99 (49 341) | 59.60 (48 323) | 0.809 [0.79 to 0.83] | – | – | – | |||
| Year 5, follow-up | 45.91 (49 998) | 54.56 (47 701) | 0.844 [0.82 to 0.86] | – | – | – | |||
| Smabrekke23 2002d | 1–15 yr | Patients receiving ABx of those consulting with acute otitis media | 155/210 (73.8%) | 114/124 (91.9%) | 0.25 [0.11 to 0.53] | 6 | – | <0.001 | Moderate |
| Wilson24 2003b | <2 yr | Mean change in ABx/100 Medicare services | −0.78 (+−1.3) | 0.35 (+−1.7) | – | – | 1.13 | 0.03 | Moderate |
↵a Cluster randomised controlled trial.
↵b No absolute numbers given.
↵c Pre- and post-design: intervention = post; control = pre.
↵d Non-randomised controlled trial.
↵e Within-group significance. ABx = antibiotic prescriptions. mo = month. NNT = Number needed to treat. NR = not reported. NS = not significant. yr = year. Italicised P-values were those reported in original study.