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Government policy interventions to reduce human antimicrobial use: A systematic review and evidence map

Van Katwyk, S. R.; Grimshaw, J. M.; et al (2019) C2

BACKGROUND: Growing political attention to antimicrobial resistance (AMR) offers a rare opportunity for achieving meaningful action. Many governments have developed national AMR action plans, but most have not yet implemented policy interventions to reduce antimicrobial overuse. A systematic evidenc ... e map can support governments in making evidence-informed decisions about implementing programs to reduce AMR, by identifying, describing, and assessing the full range of evaluated government policy options to reduce antimicrobial use in humans. METHODS AND FINDINGS: Seven databases were searched from inception to January 28, 2019, (MEDLINE, CINAHL, EMBASE, PAIS Index, Cochrane Central Register of Controlled Trials, Web of Science, and PubMed). We identified studies that (1) clearly described a government policy intervention aimed at reducing human antimicrobial use, and (2) applied a quantitative design to measure the impact. We found 69 unique evaluations of government policy interventions carried out across 4 of the 6 WHO regions. These evaluations included randomized controlled trials (n = 4), non-randomized controlled trials (n = 3), controlled before-and-after designs (n = 7), interrupted time series designs (n = 25), uncontrolled before-and-after designs (n = 18), descriptive designs (n = 10), and cohort designs (n = 2). From these we identified 17 unique policy options for governments to reduce the human use of antimicrobials. Many studies evaluated public awareness campaigns (n = 17) and antimicrobial guidelines (n = 13); however, others offered different policy options such as professional regulation, restricted reimbursement, pay for performance, and prescription requirements. Identifying these policies can inform the development of future policies and evaluations in different contexts and health systems. Limitations of our study include the possible omission of unpublished initiatives, and that policies not evaluated with respect to antimicrobial use have not been captured in this review. CONCLUSIONS: To our knowledge this is the first study to provide policy makers with synthesized evidence on specific government policy interventions addressing AMR. In the future, governments should ensure that AMR policy interventions are evaluated using rigorous study designs and that study results are published. more

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MSF الإرشادات السريرية. دليل التشخيص والعلاج
recommended

Médecins sans Frontières (MSF) (2022) C2

Clinical Guidelines. Diagnosis and Treatment Manual.

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Minimum technical standards and recommendations for reproductive, maternal, newborn and child health care for emergency medical teams

World Health Organization WHO; Institutional research information system iris (2021) C_WHO

World Health Organization. (‎2021)‎. Minimum technical standards and recommendations for reproductive, maternal, newborn and child health care for emergency medical teams. World Health Organization.

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World Heart Federation Roadmap for Hypertension – A 2021 Update

Jemoon, P.; Séverin, T.; Amodeo, C. et al. Global Heart (2021) CC

The World Heart Federation (WHF) Roadmap series covers a large range of cardiovascular conditions. These Roadmaps identify potential roadblocks and their solutions to improve the prevention, detection and management of cardiovascular diseases and provide a generic global framework available for loca ... more

Management of diabetes A national clinical guideline

Helthcare Improvement Scotland (2017) CC2

Diabetes mellitus is a major cause of morbidity and mortality in Scotland and worldwide, with an increasing prevalence. In 2009 there were around 228,000 people registered as having diabetes in Scotland, an increase of 3.6% from the preceding year. This increase relates, in part, to the increasing a ... more

Improving the global diagnosis and management of asthma in children

Lenney, W.; Bush, A.; Fitzgerald, D.A. et al. BMJ Journals (2018) CC

Asthma is the most common chronic condition in children worldwide. It affects daytime activities, sleep and school attendance and causes anxiety to parents, families and other carers. The quality of asthma diagnosis and management globally still needs substantial improvement. From infancy to the tee ... more

Antimicrobial Resistance Curriculum Assessment Tool for Medical Education

World Health Organisation (WHO) (2024) C_WHO

The Global Action Plan on Antimicrobial Resistance (AMR) calls for making AMR a core component of professional education and training. In 2018, the World Health Organization (WHO) published Competency framework for health workers’ education and training on AMR to ensure that academic institutions ... more

Worldwide rates of diagnosis and effective treatment for cystic fibrosis

Guo, J.; Garratt, A.; Hill, A. Journal of Cystic Fibrosis (2022) CC

Time has seen management for Cystic Fibrosis (CF) advance drastically, most recently in the development of the disease-modifying triple combination therapy ivacaftor/tezacaftor/elexacaftor. There is currently limited evidence regarding both the global epidemiology of CF and access to this transforma ... more

BNF for Children 2019-2020

BMA; Royal Pharmaceutical Society, etal. (2020) C2

MSF الإرشادات السريرية. دليل التشخيص والعلاج recommended

MSF الإرشادات السريرية. دليل التشخيص والعلاج
recommended