Corteville Liz, Penfold Christopher, Lecky Donna M, Patel Sanjay
Medicines Optimisation, NHS West Hampshire Clinical Commissioning Group, Hampshire, England, UK.
Evaluation & Epidemiological Science Division, UK Health Security Agency, Bristol, England, UK.
JAC Antimicrob Resist. 2025 Apr 2;7(2):dlaf041. doi: 10.1093/jacamr/dlaf041. eCollection 2025 Apr.
To improve antimicrobial stewardship (AMS) and reduce unnecessary antibiotic prescriptions in young children in a British primary care setting.
Forty-nine general practices in the South of England each hosted a 1 h in-house workshop, facilitated by trained local pharmacy professionals. This type of educational outreach approach using TARGET (Target Antibiotics Responsibly, Guidance, Education and Tools) antibiotic materials has previously been shown to reduce antibiotic dispensing in a UK primary care setting. The workshop included a review of antibiotic prescribing data, a presentation on paediatric AMS showcasing locally agreed paediatric prescribing guidelines and safety-netting resources from the Healthier Together website, and formulation of a local action plan. The primary outcome measure was total oral antibiotic prescriptions ('items') dispensed per 1000 patients aged under 5 years for the year after the workshop, compared with the previous year's dispensing.
The median prescribing rate for children under 5 years of age changed from a baseline of 48.9 per 1000 patients prior to the intervention to a new median monthly prescribing rate of 39.0 per 1000 patients following the intervention. There was no increase in paediatric presentations to primary care following the intervention.
This low-cost intervention has the potential to reduce primary care antibiotic prescribing in children and we did not detect an increase in GP attendance rates after this intervention in our study. It could easily be rolled out nationwide.
在英国基层医疗环境中改善抗菌药物管理(AMS)并减少幼儿不必要的抗生素处方。
英格兰南部的49家全科诊所各自举办了一场由当地经过培训的药学专业人员主持的1小时内部研讨会。此前已证明,这种使用TARGET(负责任地使用抗生素、指南、教育和工具)抗生素材料的教育推广方法可减少英国基层医疗环境中的抗生素配药。该研讨会包括对抗生素处方数据的审查、一场关于儿科抗菌药物管理的讲座,展示当地商定的儿科处方指南以及来自“更健康在一起”网站的安全网资源,以及制定当地行动计划。主要结局指标是研讨会后一年每1000名5岁以下患者的口服抗生素处方总量(“项”),并与上一年的配药情况进行比较。
5岁以下儿童的处方率中位数从干预前每1000名患者48.9的基线水平变为干预后每1000名患者新的每月处方率中位数39.0。干预后初级保健机构中儿科就诊人数没有增加。
这种低成本干预措施有可能减少基层医疗中儿童的抗生素处方,并且在我们的研究中,我们未发现该干预措施后全科医生就诊率有所增加。它可以很容易地在全国范围内推广。