Inappropriate Antibiotic Prescribing in Primary Care: A Systematic Review and Implications for Clinical Practice.

Inappropriate antibiotic prescribing in primary care is a major global problem, as primary care represents the first point of contact between the patient and a health system, contributing to health system burden and resulting in antimicrobial resistance. The objective of this study is to systematically review evidence on inappropriate antibiotic prescribing in primary care. In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 recommendations, PubMed and Google Scholar were searched for relevant studies that were published in the last five years, and 12 studies that fulfilled the inclusion criteria were included. Inappropriate antibiotic prescription was highly prevalent across various income settings, particularly for respiratory tract infections such as bronchitis. Broad-spectrum antibiotics, especially amoxicillin-clavulanate, were frequently inappropriately prescribed. Factors affecting inappropriate prescribing were a combination of patient, provider, and system-level determinants. Multifaceted strategies should be considered to help improve inappropriate antibiotic prescribing in primary care.