{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T22:53:38Z","timestamp":1771368818479,"version":"3.50.1"},"reference-count":45,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2021,7,5]],"date-time":"2021-07-05T00:00:00Z","timestamp":1625443200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Ontario Ministry of Health","award":["691"],"award-info":[{"award-number":["691"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,8,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>On 1 November 2018, Choosing Wisely Canada launched their Using Antibiotics Wisely primary care campaign, which aimed to reduce unnecessary antibiotic prescriptions for respiratory tract infections (RTIs) through educational tools for patients and providers.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>We explored the impact of this campaign on antibiotic utilization in Canada.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We conducted a population-based study in Canada between January 2015 and December 2019. We used interventional autoregressive integrated moving average models to study the impact of the Using Antibiotics Wisely campaign on the prescribing rate (prescriptions per 1000 population) of RTI-indicated antibiotics. We analysed prescription rates overall and stratified by age group, drug class and province, in each month over the study period.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>There was a 1.5% reduction in the annual prescribing rate of RTI-indicated antibiotics over the study period, which was generally consistent across age groups and provinces. Following the 2018 Using Antibiotics Wisely clinician toolkit release, we observed no significant change in RTI-indicated antibiotic prescribing rates nationally (P\u2009=\u20090.13). This was consistent by age group (children, P\u2009=\u20090.91; adults, P\u2009=\u20090.58; and older adults, P\u2009=\u20090.67) and drug class (narrow-spectrum penicillins, P\u2009=\u20090.88; macrolides, P\u2009=\u20090.85; broad-spectrum penicillins, P\u2009=\u20090.60; cephalosporins, P\u2009=\u20090.45; tetracyclines, P\u2009=\u20090.55; and fluoroquinolones, P\u2009=\u20090.98). In our secondary analysis of prescription rates in provinces that self-identified as prioritizing Using Antibiotics Wisely, we observed no significant change following the launch of the campaign.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The introduction of the Using Antibiotics Wisely campaign in Canada has not caused a significant change in short-term antibiotic prescribing patterns. Community antibiotic stewardship campaigns that include components beyond education may be more impactful.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jac\/dkab205","type":"journal-article","created":{"date-parts":[[2021,6,1]],"date-time":"2021-06-01T03:15:19Z","timestamp":1622517319000},"page":"2472-2478","source":"Crossref","is-referenced-by-count":11,"title":["Measuring the impacts of the <i>Using Antibiotics Wisely<\/i> campaign on Canadian community utilization of oral antibiotics for respiratory tract infections: a time-series analysis from 2015 to 2019"],"prefix":"10.1093","volume":"76","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8976-8902","authenticated-orcid":false,"given":"Teagan","family":"Rolf von den Baumen","sequence":"first","affiliation":[{"name":"Leslie Dan Faculty of Pharmacy at the University of Toronto, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Crosby","sequence":"additional","affiliation":[{"name":"Leslie Dan Faculty of Pharmacy at the University of Toronto, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mina","family":"Tadrous","sequence":"additional","affiliation":[{"name":"Leslie Dan Faculty of Pharmacy at the University of Toronto, Toronto, Ontario, Canada"},{"name":"Women\u2019s College Hospital Research Institute, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3666-7005","authenticated-orcid":false,"given":"Kevin L.","family":"Schwartz","sequence":"additional","affiliation":[{"name":"Public Health Ontario, Toronto, Ontario, Canada"},{"name":"Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada"},{"name":"Unity Health Toronto, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tara","family":"Gomes","sequence":"additional","affiliation":[{"name":"Leslie Dan Faculty of Pharmacy at the University of Toronto, Toronto, Ontario, Canada"},{"name":"Li Ka Shing Knowledge Institute, St. Michael\u2019s Hospital, Toronto, Ontario, Canada"},{"name":"Institute of Health Policy, Management and Evaluation at the University of Toronto, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,7,5]]},"reference":[{"key":"2021081309084277100_dkab205-B1","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1186\/2047-2994-1-10","article-title":"Antimicrobial resistance programs in Canada 1995-2010: a critical evaluation","volume":"1","author":"Conly","year":"2012","journal-title":"Antimicrob Resist Infect Control"},{"key":"2021081309084277100_dkab205-B2","doi-asserted-by":"crossref","first-page":"793","DOI":"10.1016\/j.cmi.2017.08.026","article-title":"What is antimicrobial stewardship?","volume":"23","author":"Dyar","year":"2017","journal-title":"Clin Microbiol Infect"},{"key":"2021081309084277100_dkab205-B3"},{"key":"2021081309084277100_dkab205-B4"},{"key":"2021081309084277100_dkab205-B5","first-page":"48","article-title":"Ten years of inaction on antimicrobial resistance: an environmental scan of policies in Canada from 2008 to 2018","volume":"15","author":"Van Katwyk","year":"2020","journal-title":"Healthc Policy"},{"key":"2021081309084277100_dkab205-B6"},{"key":"2021081309084277100_dkab205-B7","volume-title":"Required Organizational Practices: Handbook 2020","year":"2019"},{"key":"2021081309084277100_dkab205-B8","volume-title":"Primary Care Services"},{"key":"2021081309084277100_dkab205-B9","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1186\/s12875-020-01114-z","article-title":"The viral prescription pad - a mixed methods study to determine the need for and utility of an educational tool for antimicrobial stewardship in primary health care","volume":"21","author":"Lee","year":"2020","journal-title":"BMC Fam Pract"},{"key":"2021081309084277100_dkab205-B10","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1093\/cid\/cir409","article-title":"Impact of a multipronged education strategy on antibiotic prescribing in Quebec, Canada","volume":"53","author":"Weiss","year":"2011","journal-title":"Clin Infect Dis"},{"key":"2021081309084277100_dkab205-B11","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1155\/2011\/745090","article-title":"Evaluation of the do bugs need drugs? Program in British Columbia: can we curb antibiotic prescribing?","volume":"22","author":"McKay","year":"2011","journal-title":"Can J Infect Dis Med Microbiol"},{"key":"2021081309084277100_dkab205-B12","author":"Schwartz"},{"key":"2021081309084277100_dkab205-B13","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1017\/ice.2014.41","article-title":"Antimicrobial stewardship in outpatient settings: a systematic review","volume":"36","author":"Drekonja","year":"2015","journal-title":"Infect Control Hosp Epidemiol"},{"key":"2021081309084277100_dkab205-B14","year":"2016"},{"key":"2021081309084277100_dkab205-B15"},{"key":"2021081309084277100_dkab205-B16","doi-asserted-by":"crossref","first-page":"425","DOI":"10.7326\/M15-1840","article-title":"Appropriate antibiotic use for acute respiratory tract infection in adults: advice for high-value care from the American College of Physicians and the Centers for Disease Control and Prevention","volume":"164","author":"Harris","year":"2016","journal-title":"Ann Intern Med"},{"key":"2021081309084277100_dkab205-B17"},{"key":"2021081309084277100_dkab205-B18","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1186\/s12875-020-01191-0","article-title":"Antimicrobial stewardship in the primary care setting: from dream to reality?","volume":"21","author":"Avent","year":"2020","journal-title":"BMC Fam Pract"},{"key":"2021081309084277100_dkab205-B19","doi-asserted-by":"crossref","first-page":"E360","DOI":"10.9778\/cmajo.20190175","article-title":"Unnecessary antibiotic prescribing in a Canadian primary care setting: a descriptive analysis using routinely collected electronic medical record data","volume":"8","author":"Schwartz","year":"2020","journal-title":"CMAJ Open"},{"key":"2021081309084277100_dkab205-B20","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1016\/S1473-3099(18)30676-5","article-title":"Association between urinary community-acquired fluoroquinolone-resistant Escherichia coli and neighbourhood antibiotic consumption: a population-based case-control study","volume":"19","author":"Low","year":"2019","journal-title":"Lancet Infect Dis"},{"key":"2021081309084277100_dkab205-B21","doi-asserted-by":"crossref","first-page":"ofv113","DOI":"10.1093\/ofid\/ofv113","article-title":"Association between outpatient antibiotic prescribing practices and community-associated Clostridium difficile infection","volume":"2","author":"Dantes","year":"2015","journal-title":"Open Forum Infect Dis"},{"key":"2021081309084277100_dkab205-B22","doi-asserted-by":"crossref","first-page":"1","DOI":"10.14745\/ccdr.v46i01a01","article-title":"Prescriber-led practice changes that can bolster antimicrobial stewardship in community health care settings","volume":"46","author":"Leis","year":"2020","journal-title":"Can Commun Dis Rep"},{"key":"2021081309084277100_dkab205-B23"},{"key":"2021081309084277100_dkab205-B24","doi-asserted-by":"crossref","first-page":"S27","DOI":"10.1086\/511159","article-title":"Infectious Diseases Society of America\/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults","volume":"44 Suppl 2","author":"Mandell","year":"2007","journal-title":"Clin Infect Dis"},{"key":"2021081309084277100_dkab205-B25","first-page":"1299","article-title":"Diagnosis and management of community-acquired pneumonia in adults","volume":"83","author":"Watkins","year":"2011","journal-title":"Am Fam Physician"},{"key":"2021081309084277100_dkab205-B26","doi-asserted-by":"crossref","first-page":"e45\u201367","DOI":"10.1164\/rccm.201908-1581ST","article-title":"Diagnosis and treatment of adults with community-acquired pneumonia. 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