| Blaauw and Lagarde, 2019 [38] |
Study using mystery patients being treated either by nurses in PHCs or by Private GPs for acute bronchitis In a follow-up study, mystery patients explicitly told GPs and nurses that they did not want antibiotics unless they were really necessary
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Antibiotic prescribing for acute bronchitis decreased by 20% compared with the first study (Table 1 and Table 2) Despite this, more than half of patients still received antibiotics even after stating they did not want one
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| van Hecke et al., (2019), and Epps et al., 2021 [69,106] |
Explore the perceptions among 23 HCPs in publicly funded PHCs Using semi-structured questionnaires to document attitudes and experiences of existing POCTs as well as barriers and opportunities to introducing (hypothetical) new POCTs
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Largely positive experiences among HCPs with currently available POCTs HCPs were optimistic about the potential for new POCTs to support evidence-based prescribing decisions to reduce unnecessary antibiotic prescribing and to reduce the need for further investigations. In addition, support effective communication with patients, especially when antibiotics are unlikely to be beneficial However, resources, available space and workflow disruption are currently seen as barriers to their uptake into routine care
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| De Vries et al., 2022 [89] |
Multidisciplinary audit and feedback meetings once a month at 13 PHCs Ten antibiotic prescriptions were randomly selected for a peer review audit by the team, assessed and scored for adherence to seven key measures, including antibiotic choice according to the STG/EML All measures had to be met for the prescription to be considered correct Concurrently, primary care pharmacists monitored monthly consumption for the six oral antibiotics most prescribed, e.g., amoxicillin (A), co-amoxiclav (A), penicillin (A), azithromycin (W), ciprofloxacin (W) and flucloxacillin (A)—DDDs/100 prescriptions dispensed
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Mean overall level of adherence to guidelines increased from 11% in July 2017 to 53% in June 2019 However, prescribing adherence was significantly lower in the winter and spring, concurrent with higher antibiotic prescribing and consumption—this may reflect inappropriate antibiotic prescribing for increased viral ARIs during these months Mean of 19% correct prescriptions in the first 6 months (baseline) to a mean of 47% correct prescriptions in the last 6 months of the study (p < 0.001) Reduction of 12.9 DDDs between the pre- and post-intervention periods (p = 0.0084) was documented, i.e., a 19.3% decrease in antibiotic consumption
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| Masetla et al., 2023 [107] |
The aim of the study was to provide AMS services to patients in a hospital’s outpatient department with chronic bone and joint infections presenting to the orthopaedic clinic Forty-four patients participated, with questionnaires used to assess the understanding of their conditions as well as adherence to prescribed antibiotics Review of antibiotic prescriptions with prescribers contacted if concerns including adherence to current STGs/EML
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Seventy-one antibiotics were prescribed, with 62% from the ‘Watch’ group A total of 239 interventions were made, including educating patients and clinicians The majority of interventions regarding patients were concerning knowledge of their condition and medication (n = 145; 61%) Sixty-five interventions (27%) were made regarding educating patients on adherence to prescribed antibiotics and their importance in helping resolve their condition The majority (96%) of the antibiotics were not prescribed according to the STG; however, interventions were only needed in 31% of prescribed antibiotics (n = 71) since the STG only recommends empiric therapy directed against Staphylococcus aureus The majority of the drug treatment interventions (n = 29) for the appropriate antibiotic selection (62%)
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