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Table 2 Abx prescription rates of trials with one post-intervention measurement

From: Reduction of antibiotic prescriptions for acute respiratory tract infections in primary care: a systematic review

Study

Absolute number of prescribed Abx (in %/95% CI/p value) for IG and CG; adjusted OR; RR

Difference in Abx prescription rates between corresponding study arms (in %)

Odds ratio for Abx prescriptions (95% CI; p value)

Absolute reduction of Abx prescriptions in the corresponding study arm (in %)

Briel et al. 2006

Switzerland

T1:

IG 1: 46/293 (15.7%/n.s./n.s.)

Adjusted OR: 0.86 (95% CI 0.4–1.93)

IG 2: 35/259 (13.5%/n.s./n.s.)

CG: 61/285 (21.4%/n.s./n.s.)

T1:

Δ (IG 2 − IG 1) = − 2.2%

Δ (IG 1 − CG) = − 5.7%

Δ (IG 2 − CG) = − 7.9%

T1:

IG 1 and CG: 0.68

IG 2 and CG: 0.57

IG 1 and IG 2: 1.19

n.s.

Linder et al. 2009 [25]

USA

T0: unpublished data

T1:

IG: 4601/11954 (39%/n.s./n.s.)

CG: 4316/10007 (43%/n.s./n.s.)

T1:

Δ (IG − CG) = − 4%

T1:

IG and CG: 0.83 (95% CI 0.6–1.2; p = 0.30)

n.s.

Cals et al. 2009*

Netherlands

Abx prescription rates regarding study arms (only for T1):

POCT group: 43/110 (39%/25.6–52.6/n.s.)

CST group: 28/84 (33%/19.5–47.1/n.s.)

POCT + CST-group: 27/117 (23%/11.6–34.6/n.s.)

Usual care: 80/120 (67%/53.9–79.5/n.s.)

Abx prescription rates regarding factorial groups (T1 ± T2):

POCT group:

T1: 70/227 (30.8%/21.8–39.8/n.s.)

T2: 102/227 (44.9%/35.2–54.6/n.s.)

CG for POCT = no POCT group:

T1: 108/204 (52.9%/43.0–62.8/n.s.)

T2: 119/204 (58.3%/48.5–68.1/n.s.)

Comparison of the 2 groups:

T1: p < 0.02

T2: p < 0.01

CST group:

T1: 55/201 (27.4%/25.6–36.6/n.s.)

T2: 76/201 (37.8%/28.1–47.5/n.s.)

CG for CST = no CST group:

T1: 123/230 (53.5%/43.8–63.2/n.s.)

T2: 145/230 (63%/53.6–72.4/n.s.)

Comparison of the 2 groups:

T1: p < 0.01

T2: p < 0.001

T1:

Δ (POCT group − CG) = − 28%

Δ (CST group − CG) = − 34%

Δ (POCT/CST − CG) = − 44%

Δ (POCT − CST) = + 6%

Δ (POCT − POCT/CST) = + 16%

Δ (CST − POCT/CST) = + 10%

Δ (CST − POCT) = − 6%

Δ (POCT/CS − TPOCT) = − 16%

Δ (POCT/CST − CST) = − 10%

Only calculation for T2*

Δ (cumulative POCT group − cumulative non-POCT group):

− 13.4%

Δ (cumulative CST group − cumulative non-CST group): − 25.2%

T1:

Cumulative POCT group and cumulative non-POCT group: 0.39

Cumulative POCT group and cumulative CST group: 1.18

Cumulative CST group and cumulative non-CST group: 0.33

T2:

Cumulative POCT group and cumulative non-POCT group: 0.58

Cumulative POCT group and cumulative CST group: 1.34

Cumulative CST group and cumulative non-CST group: 0.36

n.s.

Cals et al. 2010*

Netherlands

T1:

IG: 56/129 (43.4%/n.s./n.s.)

CG: 73/129 (56.6%/n.s./n.s.)

RR = 0.77 (95% CI 0.56–0.98)

T2:

IG: 68/129 (52.7%/n.s./n.s.)

CG: 84/129 (65.1%/n.s./n.s.)

RR = 0.81 (95% CI 0.62–0.99)

Only calculation for T2

T2:

Δ (IG − CG) = − 12.4%

T1:

IG and CG: 0.59

T2:

IG and CG: 0.6

n.s.

Linder et al. 2010

USA

T0: baseline (unpublished data)

T1:

IG: 3912/8406 (47%/n.s./n.s.)

CG: 4761/10082 (47%/n.s./n.s.)

T1:

Δ (IG − CG) = 0%

T1:

IG and CG: 0.97 (95% CI 0.7–1.4, p = 0.87)

n.s.

Worrall et al. 2010

Canada

T1:

IG: 33/75 (43.2%/n.s./n.s.)

CG: 32/74 (44%/n.s./n.s.)

p = 0.924

T1:

Δ (IG − CG) = − 0.8%

T1:

IG and CG: 0.97

n.s.

Llor et al. 2011

Spain

T1:

IG: 123/281 (43.8%/n.s./p < 0.001)

CG: 168/262 (64.1%/n.s./n.s.)

T1:

Δ (IG − CG) = − 20.3%

T1:

IG and CG: 0.46

n.s.

McGinn et al. 2013

USA

T1:

IG: 171/586 (29.2%/n.s./n.s.)

CG: 153/398 (38.4%/n.s./n.s.)

Comparison IG/CG:

RR 0.73 (95% CI 0.58–0.92, p = 0.008)

age-adjusted RR 0.74 (95% CI 0.60–0.92; p = 0.008)

T1:

Δ (IG − CG) = − 9.2%

T1:

IG and CG: 0.66

n.s.

Hui Min Lee et al. 2016

Singapore

T1:

IG: 94/457 (20.6%/n.s./n.s.)

CG: 81/457 (17.7%/n.s./n.s.)

T1:

Δ (IG − CG) = + 2.9%

T1:

IG and CG: 1.20 (95% CI 0.84–1.72, p = 0.313)

n.s.

  1. CRP C-reactive protein, CDSS clinical decision support system, 95% CI 95% confidence interval, CST communication skills training, CG control group, n.s. not specified, IG intervention group, RR relative risk, OR odds ratio, POCT point-of-care testing
  2. *Cals et al. 2009 and Cals et al. 2010: Antibiotic prescription data of the patient sample were captured during the index consultation (T1) and within 28 days after the index consultation. As T2 prescription rates include T1 prescription rates, this study is considered as a study with one post-intervention measurement