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The following is a summary of “Factors contributing to the variation in antibiotic prescribing among primary health care physicians: a systematic review,” published in the January 2024 issue of Primary Care by Kasse, et al.

The global rise of antibiotic resistance necessitates understanding the factors influencing antibiotic prescribing by primary healthcare physicians. For a systematic review, researchers sought to summarize the evidence on the factors contributing to variation in antibiotic prescribing among physicians in primary healthcare settings.

Following PRISMA guidelines, the review included qualitative, quantitative, and mixed-methods studies exploring factors influencing antibiotic prescription among primary healthcare physicians. Exclusions comprised editorials, opinions, reviews, and non-English studies. Databases searched included PubMed, ProQuest Health and Medicine, Web Science, and Scopus. Study quality was assessed using the Mixed Methods Appraisal Tool (Version 2018). Narrative synthesis incorporated quantitative findings.

Among 1,816 identified studies, 49, spanning 2000–2023, met eligibility criteria. Factors influencing antibiotic prescription practice and variability were categorized as physician-related, patient-related, and healthcare system-related. Influencing factors included clinical guidelines, patient and physician experience, colleagues’ prescribing practices, pharmaceutical pressure, time constraints, and financial considerations. Additional factors contributing to prescription variability included individual practice patterns, practice volume, and patient relationships, particularly for intra-physician variability.

Antibiotic prescription in primary healthcare is multifactorial, with variations influenced by various factors. Addressing these factors, intra- and inter-physician variability requires interventions to reduce diagnostic uncertainty and provide continuous medical education and training, promoting patient-centered care.

Source: bmcprimcare.biomedcentral.com/articles/10.1186/s12875-023-02223-1