Irrational Antibiotic Use in Primary Care
A special issue of Antibiotics (ISSN 2079-6382). This special issue belongs to the section "Antibiotics Use and Antimicrobial Stewardship".
Deadline for manuscript submissions: 30 June 2025 | Viewed by 2634
Special Issue Editors
Interests: equitable access and rational use of medicines
Interests: rational drug use; regulatory science
Special Issue Information
Dear Colleagues,
Primary care is responsible for the majority of antibiotic prescribing worldwide, and a substantial amount of antibiotics are used irrationally. Irrational use of antibiotics can take many forms, including the use of unnecessary antibiotics (no indication); the use of too many medicines per patient (polypharmacy); the use of non-recommended fixed-dose combinations including an antibiotic; self-medication with antibiotics without a proper clinical diagnosis (often with prescription-only medicines),; non-adherence to clinical guidelines or use in non-bacterial infections; use in inadequate dosages or with inappropriate routes of administration, such as the overuse of injections when oral formulations would be more appropriate; or treatment withdrawal before ending the recommended course (underuse).All these factors expose bacteria to sub-optimal levels of antibiotics, which are not only therapeutically ineffective but also facilitate the formation of bacterial resistance to the drug.
Irrational antibiotic use in primary care is associated with many factors. Public knowledge, attitudes, and beliefs about antibiotics are strong determinants of irrational antibiotic use. Access to antibiotics without a prescription is also a driving factor for misuse due to a potential lack of access to proper diagnosis and diagnostic tools. Moreover, leftover (remaining) antibiotics from earlier prescriptions, where the patient did not adhere to the therapy or the quantity of prescribed antibiotics exceeded the treatment duration, facilitate the practice of self-medication.
Although there is a rising number of scientific publications regarding irrational antibiotic use in primary care, the following concerns still need to be addressed: the establishment of national pharmacoepidemiology to investigate antimicrobial consumption and draw plans for how to minimize it; pharmaceutical industry involvement in the fight against irrational antibiotic use by monitoring and restricting the sale of antibiotics to community pharmacies; research on the misuse of antibiotics in veterinary practices and the environment/ ecosystem under the “one health” approach; the development of policies and regulations to limit irrational antimicrobial use in low- and middle-income countries; and the implementation of easy access and OTC dispensing of antibiotics. This Special Issue addresses these issues in line with antibiotic management in various settings.
Dr. Xiaodong Guan
Prof. Dr. Luwen Shi
Prof. Dr. Paul Little
Guest Editors
Manuscript Submission Information
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Keywords
- irrational antibiotic use
- antimicrobial resistance
- drivers
- primary care
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