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Table 2 General characteristics of the interventional studies on antibiotic prescription

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

References Region Setting Sample size/unit of analysis Study type/duration Intervention type Percentage of the prescribed antibiotics Effects of the intervention The most commonly prescribed antibiotic classes (from most to least) The most commonly prescribed antibiotics (from most to least)
Mohagheghi, et al. (1995–2001) [45] Tehran Outpatient 1,096,861 prescriptions RCT/6 months Short educational course for GPs Before: in IG, 66.8% and in CG, 71.4% After: in IG, 66.1% and in CG, 74.8% Antibiotic prescribing was less in IG than in CG (p < 0.05) Penicillin, Sulfonamides, Cephalosporin, Macrolides, Metronidazole, Aminoglycosides NM
Najaf Zare et al. [46] Shiraz Outpatient 119 GPs Quasi experimental (before and after)/one year Rational prescribing workshop (one day) Before: 47.3% After: 46.4% Relative improvement (p > 0.05) NM NM
Garjani et al. [47] Tabriz Outpatient 1135 prescriptions RCT/One month Educational intervention reviewing examples of prescriptions, principles of prescription writing, necessity of rational prescribing and use of drugs, impact of irrational use of drugs, common errors in prescribing, and rational use of injections, antibiotics, and glucocorticoids (why, where, how, and how long) Before in both groups: 40.8% After: in IG, 38.9% and in CG, 37.2% Relative improvement in prescribing (p > 0.05) Penicillin, Cephalosporin, Aminoglycosides NM
Ataei et al. [48] Kermanshah Outpatient 2040 prescriptions Quasi experimental (Before and After)/6 months Rational prescribing workshop Before: 52.2% After: 47.6% Less prescribing antibiotics (p > 0.05) NM NM
Esmaily [49] East Azarbayjan Outpatient 159 GPs CRCT/3 day Educational programs: (1) principles of prescription writing, (2) adverse reactions to drugs, (3) drug interactions, (4) injections, (5) antibiotic therapy, and (6) therapy with anti-inflammatory agents Pretest (IG: 61%, CG: 59%) No significant improvement (p-value: IG: .41 and CG: .39) NM NM
Posttest (IG: 63%, CG: 60%)
Sadeghi et al. [50] Cheharmahal Bakhtiyari Outpatient 50 physicians Quasi experimental with an external control group Feedback for patients with mean of the country, a book about rational prescribing medications, content of Iran’s drugs Before: in IG1, 59.4% and in IG2, 58.5% Relative improvement (p > 0.05) NM NM
After: in IG1, 50.3% and in IG2, 59.38%
Soleymani et al. [51] Tehran Outpatient 800 physicians RCT/3 months Four-armed randomized controlled trial: routinely conducting audit and feedback (RA&F), newly-designed audit and feedback (NA&F), printed educational materials (PEM) as well as a control arm RA&F: 50.14% None of the interventions were effective in reducing overall antibiotic use NM NM
NA&F: 47.79%
PEM: 48.19%
Control: 47.05%
  1. CG control group, CRCT cluster randomized control trial, GP general practitioner, IG intervention group, NM not mentioned, RCT randomized control trial