Irrational Antibiotic Use in Primary Care

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

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Antibiotics is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

• irrational antibiotic use
• antimicrobial resistance
• drivers
• primary care