Antibiotic prescribing in inpatient and outpatient settings in Iran: a systematic review and meta-analysis study

被引：24

作者：

Nabovati, Ehsan ^{[1
,2
]}

TaherZadeh, Zhila ^{[3
]}

Eslami, Saeid ^{[4
,5
]}

Abu-Hanna, Ameen ^{[6
]}

Abbasi, Reza ^{[1
,2
]}

机构：

[1] Kashan Univ Med Sci, Hlth Informat Management Res Ctr, Kashan, Iran

[2] Kashan Univ Med Sci, Sch Allied Hlth Profess, Dept Hlth Informat Management & Technol, Kashan, Iran

[3] Mashhad Univ Med Sci, Sch Pharm, Targeted Drug Delivery Res Ctr, Mashhad, Razavi Khorasan, Iran

[4] Mashhad Univ Med Sci, Dept Med Informat, Fac Med, Mashhad, Razavi Khorasan, Iran

[5] Mashhad Univ Med Sci, Pharmaceut Res Inst, Pharmaceut Res Ctr, Mashhad, Razavi Khorasan, Iran

[6] Univ Amsterdam, Amsterdam UMC Locat AMC, Dept Med Informat, Amsterdam, Netherlands

来源：

ANTIMICROBIAL RESISTANCE AND INFECTION CONTROL | 2021年 / 10卷 / 01期

关键词：

Antibiotic prescribing; Antibiotic utilization; Developing countries; Middle income countries; Iran; ACUTE RESPIRATORY-INFECTIONS; CLUSTER RANDOMIZED-TRIAL; GENERAL-PRACTITIONERS; ANTIINFECTIVE AGENTS; TRACT-INFECTIONS; PRESCRIPTION; CONSUMPTION; INDICATORS; COMMUNITY; CHILDREN;

D O I：

10.1186/s13756-021-00887-x

中图分类号：

R1 [预防医学、卫生学];

学科分类号：

1004 ; 120402 ;

摘要：

Background Antibiotic prescribing is common worldwide. There are several original studies about antibiotic prescribing in the healthcare setting of Iran reporting different levels of prescribing. The aim of this systematic review and meta-analysis was to determine the prevalence of antibiotic prescribing in both inpatient and outpatient settings in Iran, an example of a developing country. Methods To identify published studies on antibiotic prescribing, databases such as ISI, Scopus, PubMed, Google Scholar, and Electronic Persian were searched in Iran till January 2020. Eligible studies were those analyzing original data on the prescription and use of antibiotics in outpatient or inpatient settings in Iran. Moreover, all studies that used an intervention to improve antibiotic prescribing were included. The quality of the included studies was assessed using self-administered quality assessment criteria. The meta-analysis of prevalence of antibiotic prescribing was conducted based on the meta-analysis of observational studies in epidemiology guidelines. To calculate pooled rates, the random-effects model was used. Results A total of 54 studies (39 outpatients and 15 inpatients) were included in this study. The median of antibiotic prescribing in the outpatient and inpatient settings accounted for 45.25% and 68.2% of patients, respectively. The results of meta-analysis also showed that the antibiotic prescribing accounted for 45% of prescriptions in outpatient settings and 39.5%, 66%, and 75.3% of patients in all wards, pediatrics wards, and ICU wards of inpatient settings, respectively. The most commonly prescribed antibiotic classes in outpatient settings were penicillins, cephalosporins, and macrolides, while in inpatient settings, these were cephalosporins, penicillins, and carbapenems. There were seven studies using interventions to improve antibiotic prescribing pattern. It should be mentioned that intervention in a study had a statistically significant effect on improving antibiotic prescribing (p < .05). Conclusion Prevalence of antibiotic prescribing in Iran is high. Our findings highlight the need for urgent action to improve prescription practices. It seems that developing a national plan to improve antibiotic prescribing is necessary.

引用

页数：16