title: How can we improve antibiotic prescribing in primary care?
abstract: Antibiotic stewardship is a necessity given the worldwide antimicrobial resistance crisis. Outpatient antibiotic use represents around 90% of total antibiotic use, with more than half of these prescriptions being either unnecessary or inappropriate. Efforts to improve antibiotic prescribing need to incorporate two complementary strategies: changing healthcare professionals' behaviour, and modifying the healthcare system. In this review, we present a broad perspective on antibiotic stewardship in primary care in high and high-middle income country settings, focussing on studies published in the last five years. We present the limitations of available literature, discuss perspectives, and provide suggestions for where future work should be concentrated.
authors: a Department of Public Health Sciences , Karolinska Institutet , Stockholm , Sweden.
authors: Oliver J
authors: OJ
authors: Dyar
authors: b Department of Infectious Diseases, University Medical Centre Ljubljana and Faculty of Medicine , University of Ljubljana , Ljubljana , Slovenia.
authors: Bojana
authors: B
authors: Beović
authors: c Department of Clinical Pharmacology, University Hospital Rijeka and Medical Faculty , University of Rijeka , Rijeka , Croatia.
authors: Vera
authors: V
authors: Vlahović-Palčevski
authors: d Julius Center for Health Sciences and Primary Care , University Medical Center Utrecht , Utrecht , The Netherlands.
authors: Theo
authors: T
authors: Verheij
authors: e EA 4360 APEMAC , Université de Lorraine and Service de maladies infectieuses et tropicales, CHU de Nancy , Nancy , France.
authors: Céline
authors: C
authors: Pulcini
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003695:Delivery of Health Care / Q000592:standards / Q000639:trends; D004352:Drug Resistance, Microbial; D006801:Humans; D010506:Periodicals as Topic; D010818:Practice Patterns, Physicians' / Q000592:standards* / Q000639:trends; D011320:Primary Health Care / Q000379:methods* / Q000592:standards*
chemical_list: D000900:Anti-Bacterial Agents
keywords: Antibiotic stewardship; general practice; intervention; nurse; pharmacist