scholarly journals Antibiotic prescribing for acute respiratory tract infections in primary care: a systematic review and meta-ethnography

2011 ◽  
Vol 66 (10) ◽  
pp. 2215-2223 ◽  
Author(s):  
Sarah Tonkin-Crine ◽  
Lucy Yardley ◽  
Paul Little
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Antibiotic Prescribing ◽  
Acute Respiratory Tract Infections ◽  
Tract Infections

scholarly journals Antibiotic prescribing for acute respiratory tract infections in primary care: an updated and expanded meta-ethnography

2018 ◽  
Vol 68 (674) ◽  
pp. e633-e645 ◽  
Author(s):  
Evi Germeni ◽  
Julia Frost ◽  
Ruth Garside ◽  
Morwenna Rogers ◽  
Jose M Valderas ◽  
...  
Keyword(s):  
Primary Care ◽  
Respiratory Tract ◽  
Usual Care ◽  
Respiratory Tract Infections ◽  
Antibiotic Prescribing ◽  
Qualitative Synthesis ◽  
Acute Respiratory Tract Infections ◽  
Context Sensitive ◽  
Quality Improvement Interventions ◽  
Tract Infections

BackgroundReducing unnecessary prescribing remains a key priority for tackling the global rise of antibiotic-resistant infections.AimThe authors sought to update a 2011 qualitative synthesis of GPs’ experiences of antibiotic prescribing for acute respiratory tract infections (ARTIs), including their views of interventions aimed at more prudent prescribing. They expanded the original scope to encompass all primary care professionals (PCPs) who can prescribe or dispense antibiotics for ARTIs (for example, nurses and pharmacists).Design and settingSystematic review and meta-ethnography of qualitative studies.MethodA systematic search was conducted on MEDLINE, EMBASE, PsycINFO, CINAHL, ASSIA, and Web of Science. No date or language restrictions were used. Identified studies were grouped according to their thematic focus (usual care versus intervention), and two separate syntheses were performed.ResultsIn all, 53 articles reporting the experiences of >1200 PCPs were included. Analysis of usual-care studies showed that PCPs tend to assume multiple roles in the context of ARTI consultations (the expert self, the benevolent self, the practical self), depending on the range of intrapersonal, interpersonal, and contextual situations in which they find themselves. Analysis of intervention studies identified four possible ways in which PCPs may experience quality improvement interventions (compromise, ‘supportive aids’, source of distress, and unnecessary).ConclusionContrary to the original review, these results suggest that the use of the same intervention is experienced in a totally different way by different PCPs, and that the same elements that are perceived as benefits by some could be viewed as drawbacks by others. Acceptability of interventions is likely to increase if these are context sensitive and take into account PCPs’ varying roles and changing priorities.

scholarly journals Interventions to reduce inappropriate prescribing of antibiotics for acute respiratory tract infections: summary and update of a systematic review

2018 ◽  
Vol 46 (8) ◽  
pp. 3337-3357 ◽  
Author(s):  
Marian S. McDonagh ◽  
Kim Peterson ◽  
Kevin Winthrop ◽  
Amy Cantor ◽  
Brittany H. Lazur ◽  
...  
Keyword(s):  
Systematic Review ◽  
Decision Support ◽  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Inappropriate Prescribing ◽  
Cochrane Library ◽  
Antibiotic Prescribing ◽  
Electronic Decision Support ◽  
Acute Respiratory Tract Infections ◽  
Tract Infections

Objective Antibiotic overuse contributes to antibiotic resistance and adverse consequences. Acute respiratory tract infections (RTIs) are the most common reason for antibiotic prescribing in primary care, but such infections often do not require antibiotics. We summarized and updated a previously performed systematic review of interventions to reduce inappropriate use of antibiotics for acute RTIs. Methods To update the review, we searched MEDLINE®, the Cochrane Library (until January 2018), and reference lists. Two reviewers selected the studies, extracted the study data, and assessed the quality and strength of evidence. Results Twenty-six interventions were evaluated in 95 mostly fair-quality studies. The following four interventions had moderate-strength evidence of improved/reduced antibiotic prescribing and low-strength evidence of no adverse consequences: parent education (21% reduction, no increase return visits), combined patient/clinician education (7% reduction, no change in complications/satisfaction), procalcitonin testing for adults with RTIs of the lower respiratory tract (12%–72% reduction, no increased adverse consequences), and electronic decision support systems (24%–47% improvement in appropriate prescribing, 5%–9% reduction, no increased complications). Conclusions The best evidence supports use of specific educational interventions, procalcitonin testing in adults, and electronic decision support to reduce inappropriate antibiotic prescribing for acute RTIs without causing adverse consequences.

scholarly journals Reducing antibiotic prescribing for children with respiratory tract infections in primary care: a systematic review

2013 ◽  
Vol 63 (612) ◽  
pp. e445-e454 ◽  
Author(s):  
Talley A Vodicka ◽  
Matthew Thompson ◽  
Patricia Lucas ◽  
Carl Heneghan ◽  
Peter S Blair ◽  
...  
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Antibiotic Prescribing ◽  
Tract Infections
Sign in / Sign up

Export Citation Format

Share Document