Identifying the most effective policies for minimising inappropriate use of antibiotics: A replicability study using three WHO datasets

IF 3.6 3区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Health Policy Pub Date : 2025-02-28 DOI:10.1016/j.healthpol.2025.105269

Kathleen A. Holloway , David Henry

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引用次数: 0

Abstract

Background

Policy implementation to reduce overuse of antibiotics remains weak in many low/middle-income countries (LMIC).

Aim

Identify the most effective policies for reducing inappropriate use of antibiotics.

Methods

Data on four standard indicators of antibiotic use (lower values indicating less inappropriate use) from surveys (2006–12) and implementation of 23 policies (2007–11) were analysed. Differences in indicator scores between countries implementing and not implementing policies were calculated. The impacts of multiple policies were assessed by regression analysis. Results were combined with two previous studies, one using global data 2003–7, the other South-East Asia data 2010–2015.

Results

Data were available for 44 countries. Beneficial effects were seen in several analyses showing more active policy implementation was associated with lower antibiotic use. The number of effective policies were negatively correlated with % patients prescribed antibiotics (r -0.5, p = 0.002) and % upper respiratory tract infections prescribed antibiotics (r -0.6, p = 0.002). Correlation of average policy ranking effectiveness between this study and the earlier global study was significant (r 0.69, p < 0.001). The top six policies from average rankings across the three studies were: national body responsible for quality use of medicines; public education programs; undergraduate training of doctors on clinical guidelines; antibiotics unavailable without prescription; hospital drug and therapeutics committees; and medicines free at the point of care.

Conclusion

Essential medicines policies consistently found to be associated with lower antibiotic use should be implemented urgently.

查看原文本刊更多论文

确定最大限度减少抗生素不当使用的最有效政策：使用世卫组织三个数据集的可重复性研究

背景：在许多低收入/中等收入国家，减少抗生素过度使用的政策实施仍然薄弱。目的确定减少抗生素不当使用的最有效政策。方法分析调查（2006 - 2012年）和23项政策（2007 - 2011年）中抗生素使用4项标准指标（数值越低表明不当使用越少）的数据。计算了实施和未实施政策的国家之间指标得分的差异。通过回归分析评估多项政策的影响。结果与之前的两项研究相结合，一项研究使用2003 - 2007年的全球数据，另一项研究使用2010-2015年的东南亚数据。结果可获得44个国家的数据。在一些分析中可以看到有益的效果，表明更积极的政策实施与更低的抗生素使用有关。有效政策数量与抗菌药物使用率（r -0.5, p = 0.002）、上呼吸道感染使用率（r -0.6, p = 0.002）呈负相关。本研究与早期全球研究的平均政策排序有效性相关性显著(r 0.69, p <；0.001)。从三项研究的平均排名来看，排名前六的政策是：负责药品质量使用的国家机构；公共教育项目；对医生进行临床指导的本科培训；没有处方无法获得抗生素；医院药物和治疗委员会；在医疗点提供免费药品。结论应尽快实施基本药物政策，以降低抗生素的使用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Health Policy 医学-卫生保健

CiteScore

6.40

自引率

6.10%

发文量

157

审稿时长

3-8 weeks

期刊介绍： Health Policy is intended to be a vehicle for the exploration and discussion of health policy and health system issues and is aimed in particular at enhancing communication between health policy and system researchers, legislators, decision-makers and professionals concerned with developing, implementing, and analysing health policy, health systems and health care reforms, primarily in high-income countries outside the U.S.A.