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Factors associated with antibiotic prescribing for adults with acute conditions: an umbrella review across primary care and a systematic review focusing on primary dental care

INTRODUCTION: One way to slow the spread of resistant bacteria is by improved stewardship of antibiotics: using them more carefully and reducing the number of prescriptions. With an estimated 7%–10% of antibiotic prescriptions globally originating from dental practices and up to 80% prescribed unnec...

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Autores principales: Thompson, W, Tonkin-Crine, S, Pavitt, S H, McEachan, R R C, Douglas, G V A, Aggarwal, V R, Sandoe, J A T
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6640312/
https://www.ncbi.nlm.nih.gov/pubmed/31002336
http://dx.doi.org/10.1093/jac/dkz152
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author Thompson, W
Tonkin-Crine, S
Pavitt, S H
McEachan, R R C
Douglas, G V A
Aggarwal, V R
Sandoe, J A T
author_facet Thompson, W
Tonkin-Crine, S
Pavitt, S H
McEachan, R R C
Douglas, G V A
Aggarwal, V R
Sandoe, J A T
author_sort Thompson, W
collection PubMed
description INTRODUCTION: One way to slow the spread of resistant bacteria is by improved stewardship of antibiotics: using them more carefully and reducing the number of prescriptions. With an estimated 7%–10% of antibiotic prescriptions globally originating from dental practices and up to 80% prescribed unnecessarily, dentistry has an important role to play. To support the design of new stewardship interventions through knowledge transfer between contexts, this study aimed to identify factors associated with the decision to prescribe antibiotics to adults presenting with acute conditions across primary care (including dentistry). METHODS: Two reviews were undertaken: an umbrella review across primary healthcare and a systematic review in dentistry. Two authors independently selected and quality assessed the included studies. Factors were identified using an inductive thematic approach and mapped to the Theoretical Domains Framework (TDF). Comparisons between dental and other settings were explored. Registration number: PROSPERO_CRD42016037174. RESULTS: Searches identified 689 publications across primary care and 432 across dental care. Included studies (nine and seven, respectively) were assessed as of variable quality. They covered 46 countries, of which 12 were low and middle-income countries (LMICs). Across the two reviews, 30 factors were identified, with ‘patient/condition characteristics’, ‘patient influence’ and ‘guidelines & information’ the most frequent. Two factors were unique to dental studies: ‘procedure possible’ and ‘treatment skills’. No factor related only to LMICs. CONCLUSIONS: A comprehensive list of factors associated with antibiotic prescribing to adults with acute conditions in primary care settings around the world has been collated and should assist theory-informed design of new context-specific stewardship interventions.
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spelling pubmed-66403122019-07-24 Factors associated with antibiotic prescribing for adults with acute conditions: an umbrella review across primary care and a systematic review focusing on primary dental care Thompson, W Tonkin-Crine, S Pavitt, S H McEachan, R R C Douglas, G V A Aggarwal, V R Sandoe, J A T J Antimicrob Chemother Systematic Reviews INTRODUCTION: One way to slow the spread of resistant bacteria is by improved stewardship of antibiotics: using them more carefully and reducing the number of prescriptions. With an estimated 7%–10% of antibiotic prescriptions globally originating from dental practices and up to 80% prescribed unnecessarily, dentistry has an important role to play. To support the design of new stewardship interventions through knowledge transfer between contexts, this study aimed to identify factors associated with the decision to prescribe antibiotics to adults presenting with acute conditions across primary care (including dentistry). METHODS: Two reviews were undertaken: an umbrella review across primary healthcare and a systematic review in dentistry. Two authors independently selected and quality assessed the included studies. Factors were identified using an inductive thematic approach and mapped to the Theoretical Domains Framework (TDF). Comparisons between dental and other settings were explored. Registration number: PROSPERO_CRD42016037174. RESULTS: Searches identified 689 publications across primary care and 432 across dental care. Included studies (nine and seven, respectively) were assessed as of variable quality. They covered 46 countries, of which 12 were low and middle-income countries (LMICs). Across the two reviews, 30 factors were identified, with ‘patient/condition characteristics’, ‘patient influence’ and ‘guidelines & information’ the most frequent. Two factors were unique to dental studies: ‘procedure possible’ and ‘treatment skills’. No factor related only to LMICs. CONCLUSIONS: A comprehensive list of factors associated with antibiotic prescribing to adults with acute conditions in primary care settings around the world has been collated and should assist theory-informed design of new context-specific stewardship interventions. Oxford University Press 2019-08 2019-04-19 /pmc/articles/PMC6640312/ /pubmed/31002336 http://dx.doi.org/10.1093/jac/dkz152 Text en © The Author(s) 2019. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Systematic Reviews
Thompson, W
Tonkin-Crine, S
Pavitt, S H
McEachan, R R C
Douglas, G V A
Aggarwal, V R
Sandoe, J A T
Factors associated with antibiotic prescribing for adults with acute conditions: an umbrella review across primary care and a systematic review focusing on primary dental care
title Factors associated with antibiotic prescribing for adults with acute conditions: an umbrella review across primary care and a systematic review focusing on primary dental care
title_full Factors associated with antibiotic prescribing for adults with acute conditions: an umbrella review across primary care and a systematic review focusing on primary dental care
title_fullStr Factors associated with antibiotic prescribing for adults with acute conditions: an umbrella review across primary care and a systematic review focusing on primary dental care
title_full_unstemmed Factors associated with antibiotic prescribing for adults with acute conditions: an umbrella review across primary care and a systematic review focusing on primary dental care
title_short Factors associated with antibiotic prescribing for adults with acute conditions: an umbrella review across primary care and a systematic review focusing on primary dental care
title_sort factors associated with antibiotic prescribing for adults with acute conditions: an umbrella review across primary care and a systematic review focusing on primary dental care
topic Systematic Reviews
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6640312/
https://www.ncbi.nlm.nih.gov/pubmed/31002336
http://dx.doi.org/10.1093/jac/dkz152
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