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Abstract：
Antibiotic prescribing is common worldwide. There are several original studies about antibiotic prescribing in the healthcare setting of Iran reporting different levels of prescribing. The aim of this systematic review and meta-analysis was to determine the prevalence of antibiotic prescribing in both inpatient and outpatient settings in Iran, an example of a developing country.
To identify published studies on antibiotic prescribing, databases such as ISI, Scopus, PubMed, Google Scholar, and Electronic Persian were searched in Iran till January 2020. Eligible studies were those analyzing original data on the prescription and use of antibiotics in outpatient or inpatient settings in Iran. Moreover, all studies that used an intervention to improve antibiotic prescribing were included. The quality of the included studies was assessed using self-administered quality assessment criteria. The meta-analysis of prevalence of antibiotic prescribing was conducted based on the meta-analysis of observational studies in epidemiology guidelines. To calculate pooled rates, the random-effects model was used.
A total of 54 studies (39 outpatients and 15 inpatients) were included in this study. The median of antibiotic prescribing in the outpatient and inpatient settings accounted for 45.25% and 68.2% of patients, respectively. The results of meta-analysis also showed that the antibiotic prescribing accounted for 45% of prescriptions in outpatient settings and 39.5%, 66%, and 75.3% of patients in all wards, pediatrics wards, and ICU wards of inpatient settings, respectively. The most commonly prescribed antibiotic classes in outpatient settings were penicillins, cephalosporins, and macrolides, while in inpatient settings, these were cephalosporins, penicillins, and carbapenems. There were seven studies using interventions to improve antibiotic prescribing pattern. It should be mentioned that intervention in a study had a statistically significant effect on improving antibiotic prescribing (p < .05).
Prevalence of antibiotic prescribing in Iran is high. Our findings highlight the need for urgent action to improve prescription practices. It seems that developing a national plan to improve antibiotic prescribing is necessary.
To identify published studies on antibiotic prescribing, databases such as ISI, Scopus, PubMed, Google Scholar, and Electronic Persian were searched in Iran till January 2020. Eligible studies were those analyzing original data on the prescription and use of antibiotics in outpatient or inpatient settings in Iran. Moreover, all studies that used an intervention to improve antibiotic prescribing were included. The quality of the included studies was assessed using self-administered quality assessment criteria. The meta-analysis of prevalence of antibiotic prescribing was conducted based on the meta-analysis of observational studies in epidemiology guidelines. To calculate pooled rates, the random-effects model was used.
A total of 54 studies (39 outpatients and 15 inpatients) were included in this study. The median of antibiotic prescribing in the outpatient and inpatient settings accounted for 45.25% and 68.2% of patients, respectively. The results of meta-analysis also showed that the antibiotic prescribing accounted for 45% of prescriptions in outpatient settings and 39.5%, 66%, and 75.3% of patients in all wards, pediatrics wards, and ICU wards of inpatient settings, respectively. The most commonly prescribed antibiotic classes in outpatient settings were penicillins, cephalosporins, and macrolides, while in inpatient settings, these were cephalosporins, penicillins, and carbapenems. There were seven studies using interventions to improve antibiotic prescribing pattern. It should be mentioned that intervention in a study had a statistically significant effect on improving antibiotic prescribing (p < .05).
Prevalence of antibiotic prescribing in Iran is high. Our findings highlight the need for urgent action to improve prescription practices. It seems that developing a national plan to improve antibiotic prescribing is necessary.
摘要：
抗生素处方在世界范围内很常见。有几项关于伊朗医疗保健环境中抗生素处方的原始研究报告了不同程度的处方。这项系统评价和荟萃分析的目的是确定伊朗住院和门诊环境中抗生素处方的患病率，一个发展中国家的例子。
为了确定已发表的关于抗生素处方的研究，数据库，如ISI，Scopus,PubMed,谷歌学者，和电子波斯语在伊朗被搜索到2020年1月。合格的研究是那些分析伊朗门诊或住院环境中抗生素处方和使用原始数据的研究。此外，纳入了所有使用干预措施改善抗生素处方的研究.使用自我管理的质量评估标准评估纳入研究的质量。基于流行病学指南中观察性研究的荟萃分析，对抗生素处方的患病率进行荟萃分析。要计算合并汇率，使用随机效应模型。
本研究共纳入54项研究（门诊患者39例，住院患者15例）。门诊和住院的抗生素处方中位数分别占患者的45.25%和68.2%，分别。荟萃分析的结果还显示，抗生素处方占门诊处方的45％和39.5％，66%,所有病房中75.3%的病人，儿科病房,和ICU住院病房，分别。门诊中最常用的抗生素类是青霉素，头孢菌素,和大环内酯类，在住院期间，这些是头孢菌素，青霉素,和碳青霉烯类.有七项研究使用干预措施来改善抗生素处方模式。应该提到的是，一项研究中的干预对改善抗生素处方具有统计学上的显着影响（p<0.05）。
伊朗抗生素处方的流行率很高。我们的发现强调了采取紧急行动改善处方实践的必要性。似乎有必要制定一项改善抗生素处方的国家计划。
为了确定已发表的关于抗生素处方的研究，数据库，如ISI，Scopus,PubMed,谷歌学者，和电子波斯语在伊朗被搜索到2020年1月。合格的研究是那些分析伊朗门诊或住院环境中抗生素处方和使用原始数据的研究。此外，纳入了所有使用干预措施改善抗生素处方的研究.使用自我管理的质量评估标准评估纳入研究的质量。基于流行病学指南中观察性研究的荟萃分析，对抗生素处方的患病率进行荟萃分析。要计算合并汇率，使用随机效应模型。
本研究共纳入54项研究（门诊患者39例，住院患者15例）。门诊和住院的抗生素处方中位数分别占患者的45.25%和68.2%，分别。荟萃分析的结果还显示，抗生素处方占门诊处方的45％和39.5％，66%,所有病房中75.3%的病人，儿科病房,和ICU住院病房，分别。门诊中最常用的抗生素类是青霉素，头孢菌素,和大环内酯类，在住院期间，这些是头孢菌素，青霉素,和碳青霉烯类.有七项研究使用干预措施来改善抗生素处方模式。应该提到的是，一项研究中的干预对改善抗生素处方具有统计学上的显着影响（p<0.05）。
伊朗抗生素处方的流行率很高。我们的发现强调了采取紧急行动改善处方实践的必要性。似乎有必要制定一项改善抗生素处方的国家计划。
