evidencegaps
Cochrane · systematic review · CD003543

Interventions to improve antibiotic prescribing practices for hospital inpatients

Davey, P, Marwick, CA, Scott, CL, et al. · Cochrane Database of Systematic Reviews · 2017 · Cochrane Library

Effective Practice and Organisation of Care2 versionsAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
11
current version
GRADE rated
10
No studies
1
Included studies
NR
No studies 1 · 9.1%Ungraded 0 · 0%Very low 0 · 0%Low 3 · 27.3%Moderate 3 · 27.3%High 4 · 36.4%

Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.

Questions and results

Current version only

Effects of interventions to improve use of antibiotics on prescribing, clinical outcomes, adverse events, and effect modifiers (heterogeneity)

Population: adults or children undergoing inpatient antibiotic prophylaxis or treatment
CD003543.PUB4 (current) · 11 questions
OutcomeEffectEvidenceStatus / GRADE
Proportion of participants who were treated according to antibiotic prescribing guidelines
no estimate extracted29 studies · 23394 participantsHigh
Duration of all antibiotic treatment
no estimate extracted14 studies · 3318 participantsHigh
Mortality
no estimate extracted15827 participantsModerate
Downgraded: inconsistency, indirectness
Mean length of hospital stay per participant
no estimate extracted3834 participantsModerate
Downgraded: inconsistency, indirectness
Delay in treatment
no estimate extracted1 study · 2 participantsLow
Downgraded: inconsistency, indirectness
Negative professional culture
no estimate extracted1 participantsLow
Downgraded: inconsistency, indirectness
Effect modifier
no estimate extractedNRNo studies
Enablement
no estimate extracted29 studies · 29 participantsHigh
Restriction
no estimate extracted29 studies · 29 participantsHigh
Addition of feedback to enablement
no estimate extracted23 studies · 23 participantsModerate
Downgraded: inconsistency, indirectness
Addition of enablement to restriction
no estimate extracted29 participantsLow
Downgraded: inconsistency, indirectness

Comparison

Population: Healthcare professionals
CD003543.PUB3 · 3 questions
OutcomeEffectEvidenceStatus / GRADE
Appropriate prescribing of antibiotics
no estimate extractedNRLow
Microbial outcomes
no estimate extractedNRLow
Patient outcomes
no estimate extractedNRModerate