Educational interventions and contextual factors for optimising antibiotic prescription in paediatric uncomplicated acute respiratory tract infections in primary care: scoping review of reviews
Abstract Background Inappropriate antibiotic prescription in paediatric uncomplicated acute respiratory tract infections (ARTIs) in primary care (PC) settings contributes to antimicrobial resistance. We aimed (1) to identify and describe educational interventions and their components to optimise ant...
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BMC
2025-05-01
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| Series: | BMC Pediatrics |
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| Online Access: | https://doi.org/10.1186/s12887-025-05688-4 |
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| author | Usue Elizondo-Alzola Claudio Rocha Leire Leache Montserrat León-García Luis Carlos Saiz Ivan Solà Camila Montesinos-Guevara Adriana-Gabriela Meade Andrea Boldú Ignasi Bolíbar Ena Niño-de-Guzmán Pablo Alonso-Coello |
| author_facet | Usue Elizondo-Alzola Claudio Rocha Leire Leache Montserrat León-García Luis Carlos Saiz Ivan Solà Camila Montesinos-Guevara Adriana-Gabriela Meade Andrea Boldú Ignasi Bolíbar Ena Niño-de-Guzmán Pablo Alonso-Coello |
| author_sort | Usue Elizondo-Alzola |
| collection | DOAJ |
| description | Abstract Background Inappropriate antibiotic prescription in paediatric uncomplicated acute respiratory tract infections (ARTIs) in primary care (PC) settings contributes to antimicrobial resistance. We aimed (1) to identify and describe educational interventions and their components to optimise antibiotic prescription for paediatric uncomplicated ARTIs in PC, and (2) to map contextual factors that may influence antibiotic prescription and the implementation of interventions. Methods We searched three electronic databases (Medline, CINAHL and Epistemonikos) to identify reviews on the effectiveness of educational interventions and contextual factors, for optimising antibiotic prescription (Concept) in paediatric uncomplicated ARTIs (Population) in PC (Context). We included reviews that reported explicitly the search strategy used. Two previously calibrated reviewers independently screened the literature, extracted data, and assessed the methodological limitations. We applied the “best-fit framework synthesis approach”, based on the main constructs of the Consolidated Framework for Implementation Research, and coded the data deductively by groups of analysis for reviews reporting effectiveness (e.g. antibiotic or consultation rate) or by thematic synthesis for reviews reporting contextual factors (e.g. healthcare professionals’ knowledge) based on a logic model. Results We identified 11 reviews evaluating education intervention and their characteristics, including 182 interventions with at least one educational component (educational intervention plus another type, educational or non-educational), with 136 providing information on characteristics and effectiveness. Successful interventions’ characteristics were related to the kind of intervention (e.g. communication skill training), mode of delivery (e.g. face to face), and target population (e.g. parents/caregivers). From the 22 reviews on contextual factors, healthcare professionals’ attitudes and perceptions, knowledge, and health system and professionals’ teams’ organization (inner setting), were the most frequent themes; less information was available on individuals´ characteristics (parents/children) and on outer setting (e.g. policies). Conclusion We identified a large number of heterogeneous educational interventions. Combining educational interventions plus another type targeting both parents/caregivers and healthcare professionals, and considering their needs and their context may improve antibiotic prescribing in children. Further research is needed on consultation rate, knowledge, attitudes, and satisfaction outcomes and contextual factors, as well as on the cost-effectiveness of the interventions. Registration The protocol was published in OSF iRegistries in May 2021 (Elizondo-Alzola, U). |
| format | Article |
| id | doaj-art-68aadee2344346ca81e37964efde98f0 |
| institution | OA Journals |
| issn | 1471-2431 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pediatrics |
| spelling | doaj-art-68aadee2344346ca81e37964efde98f02025-08-20T02:00:14ZengBMCBMC Pediatrics1471-24312025-05-0125112410.1186/s12887-025-05688-4Educational interventions and contextual factors for optimising antibiotic prescription in paediatric uncomplicated acute respiratory tract infections in primary care: scoping review of reviewsUsue Elizondo-Alzola0Claudio Rocha1Leire Leache2Montserrat León-García3Luis Carlos Saiz4Ivan Solà5Camila Montesinos-Guevara6Adriana-Gabriela Meade7Andrea Boldú8Ignasi Bolíbar9Ena Niño-de-Guzmán10Pablo Alonso-Coello11Institut de Recerca Sant Pau (IR Sant Pau)Centro Cochrane Iberoamericano, Institut de Recerca Sant Pau (IR Sant Pau)Pharmacy and Services Sub-Directorate, Navarre Health ServiceInstitut de Recerca Sant Pau (IR Sant Pau)Navarra Institute for Health Research (IdiSNA)Centro Cochrane Iberoamericano, Institut de Recerca Sant Pau (IR Sant Pau)Centro de Investigación en Epidemiología Clínica y Salud Pública (CISPEC), Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTECentro Cochrane Iberoamericano, Institut de Recerca Sant Pau (IR Sant Pau)Centro Cochrane Iberoamericano, Institut de Recerca Sant Pau (IR Sant Pau)Servicio de Epidemiología y Salud Pública, Hospital de la Santa Creu i Sant PauCentro Cochrane Iberoamericano, Institut de Recerca Sant Pau (IR Sant Pau)Centro Cochrane Iberoamericano, Institut de Recerca Sant Pau (IR Sant Pau)Abstract Background Inappropriate antibiotic prescription in paediatric uncomplicated acute respiratory tract infections (ARTIs) in primary care (PC) settings contributes to antimicrobial resistance. We aimed (1) to identify and describe educational interventions and their components to optimise antibiotic prescription for paediatric uncomplicated ARTIs in PC, and (2) to map contextual factors that may influence antibiotic prescription and the implementation of interventions. Methods We searched three electronic databases (Medline, CINAHL and Epistemonikos) to identify reviews on the effectiveness of educational interventions and contextual factors, for optimising antibiotic prescription (Concept) in paediatric uncomplicated ARTIs (Population) in PC (Context). We included reviews that reported explicitly the search strategy used. Two previously calibrated reviewers independently screened the literature, extracted data, and assessed the methodological limitations. We applied the “best-fit framework synthesis approach”, based on the main constructs of the Consolidated Framework for Implementation Research, and coded the data deductively by groups of analysis for reviews reporting effectiveness (e.g. antibiotic or consultation rate) or by thematic synthesis for reviews reporting contextual factors (e.g. healthcare professionals’ knowledge) based on a logic model. Results We identified 11 reviews evaluating education intervention and their characteristics, including 182 interventions with at least one educational component (educational intervention plus another type, educational or non-educational), with 136 providing information on characteristics and effectiveness. Successful interventions’ characteristics were related to the kind of intervention (e.g. communication skill training), mode of delivery (e.g. face to face), and target population (e.g. parents/caregivers). From the 22 reviews on contextual factors, healthcare professionals’ attitudes and perceptions, knowledge, and health system and professionals’ teams’ organization (inner setting), were the most frequent themes; less information was available on individuals´ characteristics (parents/children) and on outer setting (e.g. policies). Conclusion We identified a large number of heterogeneous educational interventions. Combining educational interventions plus another type targeting both parents/caregivers and healthcare professionals, and considering their needs and their context may improve antibiotic prescribing in children. Further research is needed on consultation rate, knowledge, attitudes, and satisfaction outcomes and contextual factors, as well as on the cost-effectiveness of the interventions. Registration The protocol was published in OSF iRegistries in May 2021 (Elizondo-Alzola, U).https://doi.org/10.1186/s12887-025-05688-4Antibiotic prescriptionRespiratory tract infectionsChildrenPaediatricsPrimary careEducational interventions |
| spellingShingle | Usue Elizondo-Alzola Claudio Rocha Leire Leache Montserrat León-García Luis Carlos Saiz Ivan Solà Camila Montesinos-Guevara Adriana-Gabriela Meade Andrea Boldú Ignasi Bolíbar Ena Niño-de-Guzmán Pablo Alonso-Coello Educational interventions and contextual factors for optimising antibiotic prescription in paediatric uncomplicated acute respiratory tract infections in primary care: scoping review of reviews BMC Pediatrics Antibiotic prescription Respiratory tract infections Children Paediatrics Primary care Educational interventions |
| title | Educational interventions and contextual factors for optimising antibiotic prescription in paediatric uncomplicated acute respiratory tract infections in primary care: scoping review of reviews |
| title_full | Educational interventions and contextual factors for optimising antibiotic prescription in paediatric uncomplicated acute respiratory tract infections in primary care: scoping review of reviews |
| title_fullStr | Educational interventions and contextual factors for optimising antibiotic prescription in paediatric uncomplicated acute respiratory tract infections in primary care: scoping review of reviews |
| title_full_unstemmed | Educational interventions and contextual factors for optimising antibiotic prescription in paediatric uncomplicated acute respiratory tract infections in primary care: scoping review of reviews |
| title_short | Educational interventions and contextual factors for optimising antibiotic prescription in paediatric uncomplicated acute respiratory tract infections in primary care: scoping review of reviews |
| title_sort | educational interventions and contextual factors for optimising antibiotic prescription in paediatric uncomplicated acute respiratory tract infections in primary care scoping review of reviews |
| topic | Antibiotic prescription Respiratory tract infections Children Paediatrics Primary care Educational interventions |
| url | https://doi.org/10.1186/s12887-025-05688-4 |
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