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Fig 1.

Flowchart of search strategy and screening results.

*Some studies contributed more than one estimate to the meta-analyses.

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Table 1.

Characteristics of included studies measuring the antibiotic use rates in long-term care facilities.

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Table 2.

Pooled estimates from meta-analysis of point prevalence of antibiotic use by region.

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Table 3.

Meta-regression of point prevalence estimates of antibiotic use in long-term care facilities (N = 123).

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Fig 2.

Meta-analysis by region of twelve-month period prevalence of antibiotic use.

CI is confidence interval. Markers for individual studies are proportional to the studies’ weight in generating the region estimate.

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Table 4.

Meta-regression of 12-month prevalence estimates of antibiotic use in long-term care facilities (N = 19).

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Fig 3.

Meta-analysis by region of the percent of appropriate prescriptions according to McGeer criteria.

CI is confidence interval. Markers for individual studies are proportional to the studies’ weight in generating the region estimate.

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Table 5.

Meta-regression of the percentage of appropriate a antibiotic courses in long-term care facilities (N = 8).

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Fig 4.

Classes of three most frequently used antibiotics reported by studies.

J01C is penicillins; J01D is cephalosporins; J01M is quinolones; J01X is other classes (includes only methenamine and nitrofurantoin); J01A is tetracyclines; J01F is macrolides. Classes J01M, J01A and J01F are on the World Health Organization’s (WHO) AWaRe ‘Watch List’ and should be targeted for reduced use due to high resistance potential. Studies including data from 2017 or later are indicated with an asterisk. The WHO AWaRe list was first published in 2017.

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