Photo Credit: Banjongseal324

The following is a summary of “Educational interventions and contextual factors for optimising antibiotic prescription in paediatric uncomplicated acute respiratory tract infections in primary care: scoping review of reviews,” published in the May 2025 issue of BMC Pediatrics by Elizondo-Alzola et al. 

In primary care (PC) settings, inappropriate antibiotic prescribing for pediatric uncomplicated acute respiratory tract infections (ARTIs), within pulmonology, contributed to antimicrobial resistance (AMR). 

Researchers conducted a retrospective study to identify educational interventions optimizing antibiotic prescribing for pediatric uncomplicated ARTIs in PC and to map contextual factors affecting prescribing and intervention implementation.  

They searched 3 electronic databases—Medline, CINAHL, and Epistemonikos—to identify reviews on educational interventions and contextual factors for optimizing antibiotic prescription (Concept) in pediatric uncomplicated ARTIs (Population) in PC (Context). Reviews with explicit search strategies were included and 2 calibrated reviewers independently screened extracted data and evaluated methodological limitations. The “best-fit framework synthesis approach” was applied using the Consolidated Framework for Implementation Research (CFIR) constructs. Data were deductively coded by analysis groups for effectiveness outcomes (e.g., antibiotic or consultation rate) or thematically synthesized for contextual factors (e.g., healthcare professionals’ (HCPs) knowledge) following a logic model.  

The results showed that 11 reviews assessed educational interventions, covering 182 interventions with at least 1 educational component, of which 136 reported on characteristics and effectiveness. Effective interventions were linked to type (e.g., communication skill training), delivery mode (e.g., face to face), and target groups (e.g., parents/caregivers). Among 22 reviews on contextual factors, HCPs’ attitudes, knowledge, and health system organization (inner setting) were most common, while fewer data addressed individual characteristics (parents/children) and external factors (outer setting, e.g., policies).  

Investigators concluded that combining diverse educational interventions targeting both parents/caregivers and HCPs while addressing their needs and context may improve antibiotic prescribing in children, but further research on outcomes and cost-effectiveness was needed. 

Source: bmcpediatr.biomedcentral.com/articles/10.1186/s12887-025-05688-4