Al Hussain Sarah Khalid, Deslandes Rhian, Edwards Deborah, Hodson Karen Louise
School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Cardiff CF10 3NB, UK.
College of Clinical Pharmacy, King Faisal University, Hofuf 31982, Saudi Arabia.
Antibiotics (Basel). 2025 Jan 16;14(1):100. doi: 10.3390/antibiotics14010100.
BACKGROUND/OBJECTIVES: The rapid spread of antimicrobial resistance (AMR) presents a critical threat to global health. Primary care plays a significant role in this crisis, with oral antibacterial drugs among the most prescribed medications. Antibacterial prescribing rates are often high and complicated in out-of-hours (OOH) services, including weekdays outside regular hours, weekends, and holidays, potentially exacerbating AMR. This review aims to identify the existing literature on oral antibacterial drug prescribing within primary care OOH services.
This review followed established frameworks, adhered to PRISMA-ScR guidelines, and the protocol was registered on Open Science Framework. Seven databases were searched from 2017 to May 2022. Data were summarised, tabulated, and presented narratively to explore themes and patterns that aligned with the review objectives.
The search identified 28 studies from nine high-income countries, mainly the UK (n = 6) and Belgium (n = 5). Most were quantitative studies (n = 23). Key areas identified included common oral antibacterial prescriptions, prescribing trends, presentations and conditions managed in OOH services, factors and predictors associated with prescribing, prescribing appropriateness, the impact of interventions on prescribing, prescribing in the context of COVID-19, patient satisfaction and expectations, and the challenges encountered, such as factors influencing prescribing behaviour and decision making, safety netting, and communication.
This review highlights key areas around oral antibacterial prescribing in primary care OOH services. Despite the numerous articles identified covering various areas within OOH services, the variability in OOH services approaches across countries and studies complicates the comparison of practice. Further research is needed to better understand practices in these settings.
背景/目的：抗菌药物耐药性（AMR）的迅速传播对全球健康构成了重大威胁。初级医疗保健在这场危机中发挥着重要作用，口服抗菌药物是最常开具的药物之一。在非工作时间（OOH）服务中，包括工作日的非工作时间、周末和节假日，抗菌药物的处方率往往很高且情况复杂，这可能会加剧AMR。本综述旨在识别有关初级医疗保健OOH服务中口服抗菌药物处方的现有文献。
本综述遵循既定框架，遵守PRISMA-ScR指南，且方案已在开放科学框架上注册。检索了2017年至2022年5月的七个数据库。对数据进行了总结、制表，并以叙述方式呈现，以探索与综述目标相符的主题和模式。
检索确定了来自九个高收入国家的28项研究，主要是英国（n = 6）和比利时（n = 5）。大多数是定量研究（n = 23）。确定的关键领域包括常见的口服抗菌药物处方、处方趋势、OOH服务中处理的症状和病症、与处方相关的因素和预测因素、处方的适宜性、干预措施对处方的影响、COVID-19背景下的处方、患者满意度和期望，以及遇到的挑战，如影响处方行为和决策的因素、安全网和沟通。
本综述突出了初级医疗保健OOH服务中口服抗菌药物处方的关键领域。尽管已识别出大量涵盖OOH服务各个领域的文章，但各国和各研究中OOH服务方法的差异使实践比较变得复杂。需要进一步研究以更好地了解这些环境中的实践情况。
