CoChat
Sign Up
Cited by 123Antibiotic Use and ResistanceHealthcare cost, quality, practicesSurgical site infection prevention

Factors associated with antibiotic prescribing for adults with acute conditions: an umbrella review across primary care and a systematic review focusing on primary dental care

Open access
Thompson, W, Tonkin-Crine, S, Pavitt, S H, McEachan, R R C, Douglas, G V A, Aggarwal, V R, Sandoe, J A T·2019·Journal of Antimicrobial Chemotherapy
DOI 10.1093/jac/dkz152PMC PMC6640312
Open this paper in CoChat — free accountOpen PDF

Abstract

INTRODUCTION: One way to slow the spread of resistant bacteria is by improved stewardship of antibiotics: using them more carefully and reducing the number of prescriptions. With an estimated 7%-10% of antibiotic prescriptions globally originating from dental practices and up to 80% prescribed unnecessarily, dentistry has an important role to play. To support the design of new stewardship interventions through knowledge transfer between contexts, this study aimed to identify factors associated with the decision to prescribe antibiotics to adults presenting with acute conditions across primary care (including dentistry). METHODS: Two reviews were undertaken: an umbrella review across primary healthcare and a systematic review in dentistry. Two authors independently selected and quality assessed the included studies. Factors were identified using an inductive thematic approach and mapped to the Theoretical Domains Framework (TDF). Comparisons between dental and other settings were explored. Registration number: PROSPERO_CRD42016037174. RESULTS: Searches identified 689 publications across primary care and 432 across dental care. Included studies (nine and seven, respectively) were assessed as of variable quality. They covered 46 countries, of which 12 were low and middle-income countries (LMICs). Across the two reviews, 30 factors were identified, with 'patient/condition characteristics', 'patient influence' and 'guidelines & information' the most frequent. Two factors were unique to dental studies: 'procedure possible' and 'treatment skills'. No factor related only to LMICs. CONCLUSIONS: A comprehensive list of factors associated with antibiotic prescribing to adults with acute conditions in primary care settings around the world has been collated and should assist theory-informed design of new context-specific stewardship interventions.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1093/jac/dkz152

Cites

42 of 42 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Relatively few trials of ABS interventions have, to date, been conducted in dental compared with medical settings.

    “Relatively few trials of ABS interventions have, to date, been conducted in dental compared with medical settings.9,10”

    From International Consensus on a Dental Antibiotic Stewardship Core Outcome Set (2023) · cites this paper as [9]

    The Discussion reports a sparse dental literature base and says a review found five antibiotic-stewardship intervention tests in general dental practices. The Introduction contrasts extensive medical evidence with sparse dental evidence, but it does not compare the numbers of intervention trials in medical and dental settings. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 4

  1. [3]Cleveland J, Kohn W. Antimicrobial resistance and dental care: a CDC perspective. Dent Abstr 1998; 43: 108– 10.
  2. [22]Pearson M, Doble A, Glogowski R et al Antibiotic Prescribing and Resistance: Views from LMIC Prescribing and Dispensing Professionals. Report to WHO AMR Secretariat. London: London School of Hygiene and Tropical Medicine, 2018.
  3. [27]Critical Appraisal Skills Programme C. CASP Checklist: 10 Questions to Help You Make Sense of a Systematic Review https://casp-uk.net/wp-content/uploads/2018/01/CASP-Systematic-Review-Checklist_2018.pdf.
  4. [52]Conner M, Norman P. Predicting Health Behaviour. Maidenhead: McGraw-Hill Education (UK), 2005.

Cited by

Sorted by citations

Related

Authors
Thompson, W., Tonkin-Crine, S., Pavitt, S. H., McEachan, R. R. C., Douglas, G. V. A., Aggarwal, V. R., & Sandoe, J. A. T.
Affiliations
  • University of Leeds (GB)
  • University of Oxford (GB)
  • Bradford Royal Infirmary (GB)
Corresponding author
Thompson, W
ORCID
Venue
Journal of Antimicrobial Chemotherapy
Publisher
Oxford University Press (OUP)
Published
2019-04-19
Volume
74
Issue
8
Pages
2139-2152
ISSN
  • 0305-7453 (ISSN-L)
  • 1460-2091
DOI
10.1093/jac/dkz152
PMC
PMC6640312
OpenAlex
W2935978760
Cited by
123
References
42
Citations by year
2026: 16 · 2025: 13 · 2024: 23 · 2023: 13 · 2022: 15 · 2021: 18 · 2020: 21 · 2019: 3
FWCI
1.60
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Antimicrobial Chemotherapy (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (acceptedVersion)
  • Research Explorer (The University of Manchester) (submittedVersion, cc-by-nc)
Funders
  • University of Leeds Anniversary Research Scholarship
  • National Institute for Health Research
  • NIHR Doctoral Research Fellowship (DRF-2016–09-148)
  • NIHR
  • Health Protection Research Unit
  • HPRU
  • Healthcare Associated Infections and Antimicrobial Resistance
  • University of Oxford
  • Public Health England
  • PHE (HPRU-2012–10041)
Topics
  • Life Sciences › Immunology and Microbiology › Applied Microbiology and Biotechnology › Antibiotic Use and Resistance
  • Health Sciences › Health Professions › General Health Professions › Healthcare cost, quality, practices
  • Health Sciences › Medicine › Surgery › Surgical site infection prevention
Keywords
antibiotic prescribing, antibiotic stewardship, dental care, primary care, acute conditions, prescribing determinants, Theoretical Domains Framework, antimicrobial resistance, low- and middle-income countries, prescribing guidelines, patient influence
MeSH terms
Clinical Decision-Making, Antimicrobial Stewardship, Systematic Reviews as Topic, Acute Disease, Adult, Anti-Bacterial Agents, Dental Care, Humans, Practice Patterns, Physicians', Drug Prescriptions, Primary Health Care

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review