Inappropriate Antibiotic Prescribing in Primary Care: A Systematic Review and Implications for Clinical Practice

Area of Science:

• Public Health
• Infectious Diseases
• Pharmacology

Background:

• Inappropriate antibiotic prescribing in primary care is a significant global health issue.
• It contributes to increased healthcare burden and the development of antimicrobial resistance.
• Primary care settings are the initial point of contact for most patients.

Purpose of the Study:

• To systematically review the existing evidence on inappropriate antibiotic prescribing practices in primary care settings worldwide.
• To identify the prevalence, patterns, and influencing factors of antibiotic misuse in primary care.

Main Methods:

• A systematic literature search was conducted using PubMed and Google Scholar, adhering to PRISMA 2020 guidelines.
• Studies published within the last five years were included, with 12 studies meeting the final inclusion criteria.
• Data extraction focused on prevalence, types of infections, antibiotics used, and determinants of prescribing.

Main Results:

• Inappropriate antibiotic prescriptions were highly prevalent across diverse economic settings, particularly for respiratory tract infections like bronchitis.
• Broad-spectrum antibiotics, notably amoxicillin-clavulanate, were frequently prescribed inappropriately.
• Prescribing patterns were influenced by a complex interplay of patient, provider, and health system factors.

Conclusions:

• Addressing inappropriate antibiotic prescribing requires comprehensive, multifaceted strategies.
• Interventions should target patient, provider, and system-level determinants to optimize antibiotic use in primary care.
• Improving antibiotic stewardship in primary care is crucial for combating antimicrobial resistance.