Table 2 General characteristics of the interventional studies on antibiotic prescription
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/3Â 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/3Â 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% |