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Alves PG, Hayward G, Leydon G, et al. Antibiotic prescribing in UK out-of-hours primary care services: a realist-informed scoping review of training and guidelines for healthcare professionals. BJGP Open. 2021;5(3)doi: 10.3399/BJGPO.2020.0167.
Alves, P. G., Hayward, G., Leydon, G., Barnes, R., Woods, C., Webb, J., Booker, M., Ireton, H., Latter, S., Little, P., Moore, M., Nicholls, C. L., & Stevenson, F. (2021). Antibiotic prescribing in UK out-of-hours primary care services: a realist-informed scoping review of training and guidelines for healthcare professionals. BJGP open, 5(3), . https://doi.org/10.3399/BJGPO.2020.0167
Alves, Paula Gomes, et al. "Antibiotic prescribing in UK out-of-hours primary care services: a realist-informed scoping review of training and guidelines for healthcare professionals." BJGP open vol. 5,3 (2021). doi: https://doi.org/10.3399/BJGPO.2020.0167
Alves PG, Hayward G, Leydon G, Barnes R, Woods C, Webb J, Booker M, Ireton H, Latter S, Little P, Moore M, Nicholls CL, Stevenson F. Antibiotic prescribing in UK out-of-hours primary care services: a realist-informed scoping review of training and guidelines for healthcare professionals. BJGP Open. 2021 Jun 30;5(3). doi: 10.3399/BJGPO.2020.0167. Print 2021 Jun. PMID: 33757961; PMCID: PMC8278500.
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BJGP Open. 2021 Jun 30;5(3). doi: 10.3399/BJGPO.2020.0167. Print 2021 Jun.

Antibiotic prescribing in UK out-of-hours primary care services: a realist-informed scoping review of training and guidelines for healthcare professionals.

BJGP open

Paula Gomes Alves, Gail Hayward, Geraldine Leydon, Rebecca Barnes, Catherine Woods, Joseph Webb, Matthew Booker, Helen Ireton, Sue Latter, Paul Little, Michael Moore, Clare-Louise Nicholls, Fiona Stevenson

Affiliations

  1. University of Greenwich, London, UK.
  2. University of Oxford, Oxford, UK.
  3. University of Southampton, Southampton, UK.
  4. University of Bristol, Bristol, UK.
  5. Registered Nurse, Solent NHS Trust, Portsmouth, UK.
  6. Registered Nurse, BrisDoc Heathcare Services, Bristol, UK.
  7. University College London, London, UK [email protected].

PMID: 33757961 PMCID: PMC8278500 DOI: 10.3399/BJGPO.2020.0167

Abstract

BACKGROUND: Antibiotic overuse has contributed to antimicrobial resistance, which is a global public health problem. In the UK, despite the fall in rates of antibiotic prescription since 2013, prescribing levels remain high in comparison with other European countries. Prescribing in out-of-hours (OOH) care provides unique challenges for prudent prescribing, for which professionals may not be prepared.

AIM: To explore the guidance available to professionals on prescribing antibiotics for common infections in OOH primary care within the UK, with a focus on training resources, guidelines, and clinical recommendations.

DESIGN & SETTING: A realist-informed scoping review of peer-reviewed articles and grey literature.

METHOD: The review focused on antibiotic prescribing OOH (for example, clinical guidelines and training videos). General prescribing guidance was searched whenever OOH-focused resources were unavailable. Electronic databases and websites of national agencies and professional societies were searched following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards. Findings were organised according to realist review components, that is, mechanisms, contexts, and outcomes.

RESULTS: In total, 46 clinical guidelines and eight training resources were identified. Clinical guidelines targeted adults and children, and included recommendations on prescription strategy, spectrum of the antibiotic prescribed, communication with patients, treatment duration, and decision-making processes. No clinical guidelines or training resources focusing specifically on OOH were found.

CONCLUSION: The results highlight a lack of knowledge about whether existing resources address the challenges faced by OOH antibiotic prescribers. Further research is needed to explore the training needs of OOH health professionals, and whether further OOH-focused resources need to be developed given the rates of antibiotic prescribing in this setting.

Copyright © 2021, The Authors.

Keywords: after-hours care; anti-bacterial agents; community care; drug resistance, bacterial; guidelines; prescribing

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