Table 1 Study characteristics
Author (year of publication) | Country | Sample size | Study design | Data source | Unit of analysis | Age group | Health sector | Prescribed antimicrobials N (%) | Inappropriate antimicrobial prescriptions N (%) | Two most commonly diagnosed infections (from most to least) | Three most commonly used antibiotic classes for RTI (from most to least) | The three most commonly used antibiotics for RTI (from most to least) |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
Wang, et al. [30] | China | 162,742 | Cross-sectional | Medical records | Prescriptions | All | Public | 138,330 (85%) | 63,438 (45.86%) | Acute sinusitis, acute pharyngitis | Cephalosporin, macrolides, penicillin | Penicillin v, ceftriaxone, Azithromycin |
Bo, et al. [31] | Malaysia | 205 | Cross-sectional | Survey (full structured questionnaire) | Patients | All | Private | 120 (58.50%) | 68 (57.1%) | Acute pharyngitis, acute bronchitis | Macrolides, penicillin | Amoxicillin, azithromycin |
Bianco, et al. [32] | Italy | 1979 | Cross-sectional | Survey (self-administered questionnaire) | Patients | All | Public | 1332 (67.3%) | 886 (66.5%) | Acute pharyngitis | Cephalosporins, macrolides | Amoxicillin, cefuroxime, azithromycin |
Bianco, et al. [17] | Italy | 565 | Cross-sectional | Survey (face-to-face interview) | Patients | Children | Public | 177 (31.3%) | 50 (28%) | Pharyngotonsillitis, common cold | Cephalosporins, quinolone | Levofloxacin, ceftriaxone |
Smith, et al. [13] | UK | 4,574,373 | Cross-sectional | Medical records | Prescriptions | All | Public | NA | 2,172,827 (48%) | Common cold, acute bronchitis | Penicillin, macrolides | Ampicillin, azithromycin |
Giuseppe, et al. [11] | Italy | 311 | Cross-sectional | Medical records | Patients | Adults | Public | 216 (69.4%) | 150 (69.4%) | Acute pharyngitis, influenzas | Penicillin, quinolone | Amoxicillin with clavulanic acid amoxicillin, azithromycin |
Arnolda, et al. [33] | Australia | 2621 | Cross-sectional | Survey (questionnaire and observation) | Patients | Children | Both | 2280.3 (87%) | 1411 (62%) | Bronchitis, common cold | Cephalosporin, macrolides | Ceftriaxone, azithromycin |
Alekaw, et al. [34] | Ethiopia | 279 | Cross-sectional | Medical records | Patients | Children | Public | 248 (88.9%) | 76 (30.8%) | Pneumonia, acute bronchitis | Penicillin, cephalosporin | Amoxicillin, ceftriaxone |
Bagger, et al. [24] | Denmark, Sweden, Russia, Argentina Spain, Lithuania | 15,022 | Cross-sectional | Survey (self-administered questionnaire and observation) | Patients | All | Public | 3755 (25%) | 1690 (45%) | Acute sinusitis, pharyngitis | Penicillins, quinolones and macrolides | Amoxicillin, levofloxacin, clarithromycin |
Bel Haj Ali, et al. [19] | Tunisia | 9886 | Cross-sectional | Survey (observation and structured questionnaire) | Patients | All | Public | 6426 (65%) | 1574 (24.5%) | Acute bronchitis, tonsillitis | Penicillin, tetracyclines | Amoxicillin, doxycycline, |
Kumari Indira, et al. [35] | India | 8910 | Cross-sectional | Prescriptions audit | Prescriptions | All | Both | 6183 (69.4%) | 3092 (50%) | Common cold, pharyngitis | Penicillin, macrolides | Amoxicillin, erythromycin |
Chandra Deb, et al. [36] | USA | 10,592 | Cross-sectional | Patient medical records | Prescriptions | All | Both | 9342 (88.2%) | 3942 (42.2%) | Acute bronchitis, pharyngitis | Penicillin, cephalosporin | Amoxicillin, ceftriaxone, doxycycline |
Shaheen, et al. [37] | Saudi Arabia | 908 | Cross-sectional | Prescriptions audit | Prescriptions | All | Both | 515 (56.7%) | 247 (48%) | Common cold, bronchitis | Cephalosporin, macrolides, penicillin | Amoxicillin, ceftriaxone, azithromycin |
Al Sous, et al. [38] | Syria | 14,913 | Cross-sectional | Medical records | Prescriptions | All | Public | 13,422 (90%) | 8053 (60%) | Acute tonsillitis, acute bronchitis | Cephalosporins, macrolides | Ceftriaxone, azithromycin |
Fu, et al. [39] | China | 10,678 | Cross-sectional | Prescriptions audit | Prescriptions | All | Public | 4752 (44.5%) | 1473 (31%) | Acute bronchitis, common cold | Cephalosporins, macrolides | Cefuroxime, ceftriaxone, amoxicillin |
Fu, et al. [40] | China | 212,036 | Cross-sectional | Prescriptions audit | Prescriptions | All | Public | 159,027 (75%) | 47,708 (30%) | Acute bronchitis, CAP | Cephalosporin, quinolone | Ceftriaxone, amoxicillin |
Ababneh, et al. [41] | Jordan | 5829 | Cross-sectional | Survey (questionnaire- interview) | Patients | Children | Public | 4570 (78.4%) | 3162 (69.2%) | Influenzas, tonsillitis | Penicillin, macrolides | Amoxicillin-clavulanate azithromycin, clarithromycin |
Nguyen, et al. [42] | Vietnam | 193,010 | Cross-sectional | Medical records | Prescriptions | All | Public | 129,317 (67%) | 58,193 (45%) | Acute pharyngitis, acute bronchitis | Penicillins, cephalosporins, | Vancomycin, cefuroxime, amoxapine |
Gonzales, et al. [43] | USA | 2270 | Cross-sectional | Medical records | Prescriptions | All | Public | 1430 (63%) | 887 (62%) | Acute bronchitis, pharyngitis | Penicillins, cephalosporins, | Azithromycin, amoxicillin, ceftriaxone |
Suttajit, et al. [44] | Thailand | 4512 | Cross-sectional | Medical records | Prescriptions | Adults | Public | 2838 (63%) | 1788 (63%) | Bronchitis, pharyngitis, | Penicillins, macrolides, fluoroquinolones, | Amoxicillin with clavulanic acidic, dicloxacillin |
Barlam, et al. [45] | USA | 4942 | Cross-sectional | Medical records | Prescriptions | All | Public | 3509 (71%) | 1579 (45%) | Bronchitis, Acute pharyngitis | Macrolides, penicillin | Roxithromycin, ceftriaxone, amoxicillin |
Ishida, et al. [46] | Japan | 3940 | Cross-sectional | Medical records | Prescriptions | Adults | Public | 3546 (90%) | 461 (13%) | Common cold, bronchitis | Penicillins, cephalosporins, | Azithromycin, amoxicillin |
Moon, et al. [27] | Sierra Leone | 777 | Cross-sectional | Survey (questionnaire interview) | Patients | Children | Pubic | NA | 218 (28%) | Bronchiolitis, pneumonia | Macrolides, penicillin | Ampicillin + gentamicin, ceftriaxone |
Keohavong, et al. [47] | Japan | 576 | Cross-sectional | Medical records | Prescriptions | Children | Public | 397 (68.8%) | 269 (68%) | Common cold | Penicillin, macrolides | Amoxicillin, ampicillin, erythromycin, |
Sánchez Choez, et al. [48] | Ecuador | 1393 | Cross-sectional | Medical records | Patients | All | Public | 523 (37.5%) | 471 (90%) | Common cold, acute tonsillitis | Cephalosporins, macrolides | Benzathine penicillin + Amoxicillin’, Benzathine penicillin + azithromycin’ |
Chang, et al. [26] | China | 74,648 | Cross-sectional | Medical records | Prescriptions | All | Public | NA | 68,527 (91.8%) | Acute tonsillitis, acute pharyngitis | Penicillin, macrolides | Co-amoxiclav, amoxicillin, azithromycin |
Alkhaldi, et al. [18] | Jordan | 73,701 | Cross-sectional | Medical records | Prescriptions | All | Public | 20,133 (27%) | 5795 (28.8%) | Tonsillitis | Cephalosporins, penicillins | Azithromycin, ceftriaxone, amoxicillin |
Butt, et al. [25] | Qatar | 75,733 | Cross-sectional | Medical records | Prescriptions | All | Private | NA | 34,080 (45%) | Acute pharyngitis, acute sinusitis | Macrolides, Fluoroquinolone | Roxithromycin, amoxicillin, levofloxacin |
Dekker, et al. [49] | Netherlands | 2724 | Cross-sectional | Medical records | Prescriptions | All | Public | 1035 (38%) | 476 (46%) | Chronic sinusitis, pneumonia | Penicillin, macrolides cephalosporins | Amoxicillin |
Gačina, et al. [50] | Croatia | 709 | Cross-sectional | Survey (structured questionnaire) | Patients | All | Public | 231 (32.6%) | 69 (30%) | - | Penicillin, cephalosporins fluoroquinolones | Ceftriaxone, amoxicillin, azithromycin, |
Lakkis, et al. [51] | Lebanon | 372 | Cross-sectional | Medical records | Prescriptions | All | Public | 328 (88%) | 131 (40%) | Acute pharyngitis, acute bronchitis | Cephalosporins, macrolides penicillins | Amoxicillin-clavulanate ceftriaxone |
Ji, et al. [52] | Japan | 1,937,379 | Cross-sectional | Medical records | Prescriptions | Adults | Public | 813,699 (42%) | 284,795 (35%) | Acute nasopharyngitis | Cephalosporins, macrolides, fluoroquinolones | Not mentioned |
Rún Sigurðardóttir, et al. [53] | Denmark and Iceland | 1428 | Cross-sectional | Prescriptions audit | Prescriptions | All | Public | 964 (67.5%) | 155 (16%) | Acute sinusitis, acute pharyngotonsillitis | Penicillin, macrolides | Not mentioned |
Nowakowska, et al. [28] | UK | 1,151,105 | Cross-sectional | Medical records | Prescriptions | All | Public | NA | 444,902 (39%) | - | Penicillins, quinolones, and macrolides | Amoxicillin, ampicillin, Phenoxymethylpenicillin |
Tobia, et al. [29] | USA | 153 | Cross-sectional | Medical records | Prescriptions | All | Public | NA | 99 (65%) | Sinusitis, CAP | Fluoroquinolones cephalosporins | Ciprofloxacin, ceftriaxone, moxifloxacin |
Vergidis, et al. [54] | USA | 617 | Cross-sectional | Medical records | Prescriptions | All | Public | 352 (57%) | 74 (24%) | Acute bronchitis, pneumonia | Penicillins, beta-lactam combination, macrolides | Amoxicillin, azithromycin, co-amoxiclav |