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Please use this identifier to cite or link to this item: http://hdl.handle.net/11375/26498
Title: Government policy interventions to reduce human antimicrobial use: protocol for a systematic review and meta-analysis
Authors: Rogers Van Katwyk S
Grimshaw JM
Mendelson M
Taljaard M
Hoffman SJ
Keywords: AMR;Antimicrobial resistance;Government;Policy;Protocol;Systematic review;Anti-Bacterial Agents;Drug Resistance, Bacterial;Drug Utilization Review;Government;Humans;Policy;Public Health Practice;Systematic Reviews as Topic
Publication Date: Dec-2017
Publisher: Springer Science and Business Media LLC
Abstract: BACKGROUND: Antimicrobial resistance (AMR) is a recognized threat to global public health. Increasing AMR and a dry pipeline of novel antimicrobial drugs have put AMR in the international spotlight. One strategy to combat AMR is to reduce antimicrobial drug consumption. Governments around the world have been experimenting with different policy interventions, such as regulating where antimicrobials can be sold, restricting the use of last-resort antimicrobials, funding AMR stewardship programs, and launching public awareness campaigns. To inform future action, governments should have access to synthesized data on the effectiveness of large-scale AMR interventions. This planned systematic review will (1) identify and describe previously evaluated government policy interventions to reduce human antimicrobial use and (2) estimate the effectiveness of these different strategies. METHODS: An electronic search strategy has been developed in consultation with two research librarians. Seven databases (MEDLINE, CINAHL, EMBASE, CENTRAL, PAIS Index, Web of Science, and PubMed excluding MEDLINE) will be searched, and additional studies will be identified using several gray literature search strategies. To be included, a study must (1) clearly describe the government policy and (2) use a rigorous design to quantitatively measure the impact of the policy on human antibiotic use. The intervention of interest is any policy intervention enacted by a government or government agency in any country to change human antimicrobial use. Two independent reviewers will screen for eligibility using criteria defined a priori. Data will be extracted with Covidence software using a customized extraction form. If sufficient data exists, a meta-analysis by intervention type will be conducted as part of the effectiveness review. However, if there are too few studies or if the interventions are too heterogeneous, data will be tabulated and a narrative synthesis strategy will be used. DISCUSSION: This evidence synthesis is intended for use by policymakers, public health practitioners, and researchers to inform future government policies aiming to address antimicrobial resistance. This review will also identify gaps in the evidence about the effectiveness of different policy interventions to inform future research priorities. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42017067514 .
metadata.dc.rights.license: Attribution - CC BY
Rights: Attribution - CC BY This Creative Commons license lets others distribute, remix, tweak, and build upon your work, even commercially, as long as they credit you for the original creation. Recommended for maximum dissemination and use of licensed materials.
URI: http://hdl.handle.net/11375/26498
metadata.dc.identifier.doi: https://doi.org/10.1186/s13643-017-0640-2
ISSN: 2046-4053
2046-4053
Appears in Collections:Faculty Publications (via McMaster Experts)

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