Which statement is a fair criticism of the study, according to the passage? (Passage: Antibiotic stewardship)

Antibiotics kill bacteria but have no effect on viruses, yet surveys in several countries show that many patients expect a prescription for colds. Each unnecessary course gives surviving bacteria the chance to develop resistance. Hospitals therefore run stewardship programmes in which a pharmacist reviews every antibiotic prescription after 48 hours, when test results are usually available. In one hospital this review reduced total antibiotic use by 15 per cent without any rise in deaths. The authors note that the study was not randomised, so other changes in the hospital could have contributed.

Answer and explanation

Correct answer: D. Without randomisation, other hospital changes may explain the fall in use

  1. Step 1: The authors give their own limitation. Step 2. They note it was not randomised, so other changes could have contributed. Answer: Without randomisation, other hospital changes may explain the fall in use. Why not the others: Deaths did not rise; the size of the reduction is not criticised; qualifications are not discussed.

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