Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2018 Nov;187(4):969-986.
doi: 10.1007/s11845-018-1774-5. Epub 2018 Mar 12.

Antibiotic use for acute respiratory tract infections (ARTI) in primary care; what factors affect prescribing and why is it important? A narrative review

Ray O'Connor  1 , Jane O'Doherty  2 , Andrew O'Regan  2 , Colum Dunne  2
Affiliations
Review

Antibiotic use for acute respiratory tract infections (ARTI) in primary care; what factors affect prescribing and why is it important? A narrative review

Ray O'Connor et al. Ir J Med Sci. 2018 Nov.

Abstract

Background: Antimicrobial resistance is an emerging global threat to health and is associated with increased consumption of antibiotics. Seventy-four per cent of antibiotic prescribing takes place in primary care. Much of this is for inappropriate treatment of acute respiratory tract infections.

Aims: To review the published literature pertaining to antibiotic prescribing in order to identify and understand the factors that affect primary care providers' prescribing decisions.

Methods: Six online databases were searched for relevant paper using agreed criteria. One hundred ninety-five papers were retrieved, and 139 were included in this review.

Results: Primary care providers are highly influenced to prescribe by patient expectation for antibiotics, clinical uncertainty and workload induced time pressures. Strategies proven to reduce such inappropriate prescribing include appropriately aimed multifaceted educational interventions for primary care providers, mass media educational campaigns aimed at healthcare professionals and the public, use of good communication skills in the consultation, use of delayed prescriptions especially when accompanied by written information, point of care testing and, probably, longer less pressurised consultations. Delayed prescriptions also facilitate focused personalised patient education.

Conclusion: There is an emerging consensus in the literature regarding strategies proven to reduce antibiotic consumption for acute respiratory tract infections. The widespread adoption of these strategies in primary care is imperative.

Keywords: Adult or paediatric; Antibacterial agent; Antibiotic prescription; Patient expectations; Upper respiratory tract infection.

PubMed Disclaimer

References

    1. Aryee A, Price N. Antimicrobial stewardship—can we afford to do without it? Br J Clin Pharmacol. 2014;79(2):173–181. - PMC - PubMed
    1. WHO. Antimicrobial Resistance. Global report on surveillance. Switzerland: 2014
    1. Bell BG, Schellevis F, Stobberingh E, Goossens H, Pringle M. A systematic review and meta-analysis of the effects of antibiotic consumption on antibiotic resistance. BMC Infect Dis. 2014;14:13. - PMC - PubMed
    1. Power RF, Linnane B, Martin R, Power N, Harnett P, Casserly B, O’Connell NH, Dunne CP. The first reported case of Burkholderia contaminans in patients with cystic fibrosis in Ireland: from the Sargasso Sea to Irish Children. BMC Pulm Med. 2016;16(1):57. - PMC - PubMed
    1. O'Connor C, Cormican M, Boo TW, McGrath E, Slevin B, O'Gorman A, Commane M, Mahony S, O'Donovan E, Powell J, Monahan R, Finnegan C, Kiernan MG, Coffey JC, Power L, O'Connell NH, Dunne CP. An Irish outbreak of New Delhi metallo-beta-lactamase (NDM)-1 carbapenemase-producing Enterobacteriaceae: increasing but unrecognized prevalence. J Hosp Infect. 2016;94(4):351–357. - PubMed

Substances

LinkOut - more resources