Martínez-González Nahara Anani, Coenen Samuel, Plate Andreas, Colliers Annelies, Rosemann Thomas, Senn Oliver, Neuner-Jehle Stefan
Institute of Primary Care, University of Zurich and University Hospital of Zurich, Zurich, Switzerland.
Department of Primary and Interdisciplinary Care (ELIZA), Centre for General Practice, University of Antwerp - Campus Drie Eiken, Wilrijk, Belgium.
BMJ Open. 2017 Jun 13;7(6):e016253. doi: 10.1136/bmjopen-2017-016253.
Respiratory tract infections (RTIs) are the most common reason for primary care (PC) consultations and for antibiotic prescribing and use. The majority of RTIs have a viral aetiology however, and antibiotic consumption is ineffective and unnecessary. Inappropriate antibiotic use contributes greatly to antibiotic resistance (ABR) leading to complications, increased adverse events, reconsultations and costs. Improving antibiotic consumption is thus crucial to containing ABR, which has become an urgent priority worldwide. We will systematically review the evidence about interventions aimed at improving the quality of antibiotic prescribing and use for acute RTI.
We will include primary peer-reviewed and grey literature of studies conducted on in-hours and out-of-hours PC patients (adults and children): (1) randomised controlled trials (RCTs), quasi-RCTs and/or cluster-RCTs evaluating the effectiveness, feasibility and acceptability of patient-targeted and clinician-targeted interventions and (2) RCTs and other study designs evaluating the effectiveness of public campaigns and regulatory interventions. We will search MEDLINE (EBSCOHost), EMBASE (Elsevier), the Cochrane Library (Wiley), CINHAL (EBSCOHost), PsychINFO (EBSCOHost), Web of Science, LILACS (Latin American and Caribbean Literature on Health Sciences), TRIP (Turning Research Into Practice) and opensgrey.eu without language restriction. We will also search the reference lists of included studies and relevant reviews. Primary outcomes include the rates of (guideline-recommended) antibiotics prescribed and/or used. Secondary outcomes include immediate or delayed use of antibiotics, and feasibility and acceptability outcomes. We will assess study eligibility and risk of bias, and will extract data. Data permitting, we will perform meta-analyses.
This is a systematic review protocol and so formal ethical approval is not required. We will not collect confidential, personal or primary data. The findings of this review will be disseminated at national and international scientific meetings.
PROSPERO trial (CRD42017035305).
呼吸道感染（RTIs）是基层医疗（PC）咨询以及抗生素处方开具和使用的最常见原因。然而，大多数呼吸道感染由病毒引起，使用抗生素无效且不必要。不适当的抗生素使用极大地促成了抗生素耐药性（ABR），导致并发症、不良事件增加、再次就诊和费用上升。因此，改善抗生素使用对于控制抗生素耐药性至关重要，抗生素耐药性已成为全球紧迫的优先事项。我们将系统回顾有关旨在提高急性呼吸道感染抗生素处方开具和使用质量的干预措施的证据。
我们将纳入针对基层医疗患者（成人和儿童）在工作时间和非工作时间进行的研究的同行评审的原始文献和灰色文献：（1）评估针对患者和针对临床医生的干预措施的有效性、可行性和可接受性的随机对照试验（RCTs）、准随机对照试验和/或整群随机对照试验，以及（2）评估公众宣传活动和监管干预措施有效性的随机对照试验和其他研究设计。我们将检索MEDLINE（EBSCOHost）、EMBASE（爱思唯尔）、Cochrane图书馆（威利）、CINHAL（EBSCOHost）、PsychINFO（EBSCOHost）、科学引文索引、LILACS（拉丁美洲和加勒比地区健康科学文献）、TRIP（将研究转化为实践）和opengrey.eu，无语言限制。我们还将检索纳入研究和相关综述的参考文献列表。主要结局包括（指南推荐的）抗生素处方开具和/或使用的比例。次要结局包括抗生素的即时或延迟使用，以及可行性和可接受性结局。我们将评估研究的合格性和偏倚风险，并提取数据。如果数据允许，我们将进行荟萃分析。
这是一项系统综述方案，因此无需正式的伦理批准。我们不会收集机密、个人或原始数据。本综述的结果将在国内和国际科学会议上传播。
PROSPERO试验（CRD42017035305）。
