Antibiotic stewardship A review of successful, evidence-based primary care strategies

Abstract

Background Antibiotic resistance is a rising global threat with only two options for mitigation:1) invent new antibiotics and/or 2) usecurrent antibiotics more wisely. InAustralia, the majority of antibiotic usageis in the community, hence primary carehas a key role.ObjectiveWith no single ‘magic bullet’, a range ofapproaches is needed. The aim of thisarticle is to describe the options andevidence in three broad categories:1) regulatory changes such as repeatsand pack sizes, 2) policy initiatives suchas public campaigns, academic detailingand education and 3) clinical strategiesincluding delayed prescribing, clinicaldecision support tools, practice-basedaudit and feedback, and patientinformation sheets.DiscussionAustralia has good antibiotic regulationand guidelines but must invest insustained primary care stewardshipprograms, which should includesurveillance, information for consumers,support for general practitioners andgeneral practice training, and an ongoingevaluation and research program