Physician-Targeted Interventions in Antibiotic Prescribing for Urinary Tract Infections in General Practice: A...

Area of Science:

• General Practice and Primary Care
• Infectious Diseases and Microbiology
• Health Services Research

Background:

• Urinary tract infections (UTIs) are a leading reason for women to consult general practitioners (GPs).
• Antibiotic prescriptions for UTIs frequently deviate from clinical guidelines, despite many infections being self-limiting.
• Interventions to modify GP prescribing for respiratory infections exist, but their efficacy for UTI care is unclear.

Purpose of the Study:

• To systematically review the effectiveness of interventions aimed at improving general practitioners' antibiotic prescribing for UTIs.
• To assess the impact of interventions on the decision to prescribe and the selection of antibiotics for UTI management.

Main Methods:

• Systematic review and meta-analysis of (cluster) randomized clinical trials.
• Searched Medline, Web of Science, and CENTRAL databases (September-December 2021).
• Included ten studies (eleven trials) evaluating interventions targeting GP prescribing behavior for UTIs.

Main Results:

• Multifaceted interventions, often including audit & feedback and educational meetings, were most common.
• Seven of nine trials showed an increased proportion of first-choice antibiotic prescriptions in intervention groups.
• Five of six studies reported a decreased proportion of broad-spectrum antibiotic use.
• However, four of eight studies observed an increase in the total number of antibiotic prescriptions for UTIs.

Conclusions:

• Interventions can effectively influence GPs' antibiotic prescribing choices for UTIs, promoting guideline-adherent options.
• Current interventions need refinement to address the overall number of antibiotic prescriptions, not just the choice.
• Future research should focus on strategies to reduce unnecessary antibiotic prescribing for UTIs in primary care.