Cargando…

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

Urinary tract infections (UTIs) are the most common reason for women to consult a general practitioner (GP). While UTIs are self-limiting in half of cases, most women are prescribed antibiotics, often in discordance with established guidelines. Researchers have employed different interventions to im...

Descripción completa

Detalles Bibliográficos
Autores principales: Cox, Stefan, Lo-A-Foe, Kelly, van Hoof, Minke, Dinant, Geert-Jan, Oudhuis, Guy, Savelkoul, Paul, Cals, Jochen, de Bont, Eefje
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9686805/
https://www.ncbi.nlm.nih.gov/pubmed/36358215
http://dx.doi.org/10.3390/antibiotics11111560
_version_ 1784835844779016192
author Cox, Stefan
Lo-A-Foe, Kelly
van Hoof, Minke
Dinant, Geert-Jan
Oudhuis, Guy
Savelkoul, Paul
Cals, Jochen
de Bont, Eefje
author_facet Cox, Stefan
Lo-A-Foe, Kelly
van Hoof, Minke
Dinant, Geert-Jan
Oudhuis, Guy
Savelkoul, Paul
Cals, Jochen
de Bont, Eefje
author_sort Cox, Stefan
collection PubMed
description Urinary tract infections (UTIs) are the most common reason for women to consult a general practitioner (GP). While UTIs are self-limiting in half of cases, most women are prescribed antibiotics, often in discordance with established guidelines. Researchers have employed different interventions to improve GPs’ prescribing behavior, especially for respiratory infections, but it is uncertain whether these are effective for UTI care. Therefore, we performed a systematic review, including (cluster) randomized clinical trials investigating the effect of interventions targeted at GPs to improve antibiotic prescriptions for UTI. From September to December 2021 we searched the Medline, Web of Science, and CENTRAL databases, ultimately including ten studies describing eleven trials. We determined the effect of the interventions on the decision to prescribe and on the choice of antibiotic. Results showed that most studies employed multifaceted interventions, most frequently including audit & feedback and/or educational meetings. Seven out of nine trials that recorded first-choice prescriptions saw an increased proportion of first-choice antibiotics in the intervention groups compared to control groups. The employed interventions also caused a decreased proportion of at least one broad-spectrum antibiotic in five out of six studies that measured broad-spectrum antibiotic prescriptions. However, the total number of antibiotic prescriptions for UTIs increased in four out of eight studies. Therefore, while effective at influencing GPs’ prescribing behavior, future interventions should also focus on improving the decision to prescribe at all.
format Online
Article
Text
id pubmed-9686805
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-96868052022-11-25 Physician-Targeted Interventions in Antibiotic Prescribing for Urinary Tract Infections in General Practice: A Systematic Review Cox, Stefan Lo-A-Foe, Kelly van Hoof, Minke Dinant, Geert-Jan Oudhuis, Guy Savelkoul, Paul Cals, Jochen de Bont, Eefje Antibiotics (Basel) Review Urinary tract infections (UTIs) are the most common reason for women to consult a general practitioner (GP). While UTIs are self-limiting in half of cases, most women are prescribed antibiotics, often in discordance with established guidelines. Researchers have employed different interventions to improve GPs’ prescribing behavior, especially for respiratory infections, but it is uncertain whether these are effective for UTI care. Therefore, we performed a systematic review, including (cluster) randomized clinical trials investigating the effect of interventions targeted at GPs to improve antibiotic prescriptions for UTI. From September to December 2021 we searched the Medline, Web of Science, and CENTRAL databases, ultimately including ten studies describing eleven trials. We determined the effect of the interventions on the decision to prescribe and on the choice of antibiotic. Results showed that most studies employed multifaceted interventions, most frequently including audit & feedback and/or educational meetings. Seven out of nine trials that recorded first-choice prescriptions saw an increased proportion of first-choice antibiotics in the intervention groups compared to control groups. The employed interventions also caused a decreased proportion of at least one broad-spectrum antibiotic in five out of six studies that measured broad-spectrum antibiotic prescriptions. However, the total number of antibiotic prescriptions for UTIs increased in four out of eight studies. Therefore, while effective at influencing GPs’ prescribing behavior, future interventions should also focus on improving the decision to prescribe at all. MDPI 2022-11-05 /pmc/articles/PMC9686805/ /pubmed/36358215 http://dx.doi.org/10.3390/antibiotics11111560 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Cox, Stefan
Lo-A-Foe, Kelly
van Hoof, Minke
Dinant, Geert-Jan
Oudhuis, Guy
Savelkoul, Paul
Cals, Jochen
de Bont, Eefje
Physician-Targeted Interventions in Antibiotic Prescribing for Urinary Tract Infections in General Practice: A Systematic Review
title Physician-Targeted Interventions in Antibiotic Prescribing for Urinary Tract Infections in General Practice: A Systematic Review
title_full Physician-Targeted Interventions in Antibiotic Prescribing for Urinary Tract Infections in General Practice: A Systematic Review
title_fullStr Physician-Targeted Interventions in Antibiotic Prescribing for Urinary Tract Infections in General Practice: A Systematic Review
title_full_unstemmed Physician-Targeted Interventions in Antibiotic Prescribing for Urinary Tract Infections in General Practice: A Systematic Review
title_short Physician-Targeted Interventions in Antibiotic Prescribing for Urinary Tract Infections in General Practice: A Systematic Review
title_sort physician-targeted interventions in antibiotic prescribing for urinary tract infections in general practice: a systematic review
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9686805/
https://www.ncbi.nlm.nih.gov/pubmed/36358215
http://dx.doi.org/10.3390/antibiotics11111560
work_keys_str_mv AT coxstefan physiciantargetedinterventionsinantibioticprescribingforurinarytractinfectionsingeneralpracticeasystematicreview
AT loafoekelly physiciantargetedinterventionsinantibioticprescribingforurinarytractinfectionsingeneralpracticeasystematicreview
AT vanhoofminke physiciantargetedinterventionsinantibioticprescribingforurinarytractinfectionsingeneralpracticeasystematicreview
AT dinantgeertjan physiciantargetedinterventionsinantibioticprescribingforurinarytractinfectionsingeneralpracticeasystematicreview
AT oudhuisguy physiciantargetedinterventionsinantibioticprescribingforurinarytractinfectionsingeneralpracticeasystematicreview
AT savelkoulpaul physiciantargetedinterventionsinantibioticprescribingforurinarytractinfectionsingeneralpracticeasystematicreview
AT calsjochen physiciantargetedinterventionsinantibioticprescribingforurinarytractinfectionsingeneralpracticeasystematicreview
AT debonteefje physiciantargetedinterventionsinantibioticprescribingforurinarytractinfectionsingeneralpracticeasystematicreview