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Article

Impact of the COVID-19 Pandemic on Community Antibiotic Prescribing and Stewardship: A Qualitative Interview Study with General Practitioners in England

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Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK
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National Institute for Health Research (NIHR) Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College London, London W12 0NN, UK
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Centre for Medication Safety and Service Quality, Pharmacy Department, Imperial College Healthcare NHS Trust, London W6 8RF, UK
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NIHR Imperial Patient Safety Translational Research Centre, Imperial College London, London W6 8RF, UK
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Department of Primary Care and Public Health, School of Public Health, Imperial College London, London W6 8RP, UK
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NIHR Applied Research Collaboration Northwest London, London W6 8RP, UK
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Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK
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NIHR Oxford Biomedical Research Centre, Oxford OX3 9DU, UK
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NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, University of Oxford, Oxford OX3 9DU, UK
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Nuffield Department of Medicine, University of Oxford, Oxford OX3 9DU, UK
*
Author to whom correspondence should be addressed.
Members of the STEP-UP Study Team are listed in the Acknowledgements section.
Academic Editor: Seok Hoon Jeong
Antibiotics 2021, 10(12), 1531; https://doi.org/10.3390/antibiotics10121531
Received: 29 October 2021 / Revised: 3 December 2021 / Accepted: 10 December 2021 / Published: 14 December 2021
(This article belongs to the Special Issue Antibiotics Use in Primary Care during COVID-19)
The COVID-19 pandemic has had a profound impact on the delivery of primary care services. We aimed to identify general practitioners’ (GPs’) perceptions and experiences of how the COVID-19 pandemic influenced antibiotic prescribing and antimicrobial stewardship (AMS) in general practice in England. Twenty-four semi-structured interviews were conducted with 18 GPs at two time-points: autumn 2020 (14 interviews) and spring 2021 (10 interviews). Interviews were audio-recorded, transcribed and analysed thematically, taking a longitudinal approach. Participants reported a lower threshold for antibiotic prescribing (and fewer consultations) for respiratory infections and COVID-19 symptoms early in the pandemic, then returning to more usual (pre-pandemic) prescribing. They perceived the pandemic as having had less impact on antibiotic prescribing for urinary and skin infections. Participants perceived the changing ways of working and consulting (e.g., proportions of remote and in-person consultations) in addition to changing patient presentations and GP workloads as influencing the fluctuations in antibiotic prescribing. This was compounded by decreased engagement with, and priority of, AMS due to COVID-19-related urgent priorities. Re-engagement with AMS is needed, e.g., through reviving antibiotic prescribing feedback and targets/incentives. The pandemic disrupted, and required adaptations in, the usual ways of working and AMS. It is now important to identify opportunities, e.g., for re-organising ways of managing infections and AMS in the future. View Full-Text
Keywords: antibiotics; antimicrobial stewardship; general practice; COVID-19; qualitative antibiotics; antimicrobial stewardship; general practice; COVID-19; qualitative
MDPI and ACS Style

Borek, A.J.; Maitland, K.; McLeod, M.; Campbell, A.; Hayhoe, B.; Butler, C.C.; Morrell, L.; Roope, L.S.J.; Holmes, A.; Walker, A.S.; Tonkin-Crine, S.; on behalf of the STEP-UP Study Team. Impact of the COVID-19 Pandemic on Community Antibiotic Prescribing and Stewardship: A Qualitative Interview Study with General Practitioners in England. Antibiotics 2021, 10, 1531. https://doi.org/10.3390/antibiotics10121531

AMA Style

Borek AJ, Maitland K, McLeod M, Campbell A, Hayhoe B, Butler CC, Morrell L, Roope LSJ, Holmes A, Walker AS, Tonkin-Crine S, on behalf of the STEP-UP Study Team. Impact of the COVID-19 Pandemic on Community Antibiotic Prescribing and Stewardship: A Qualitative Interview Study with General Practitioners in England. Antibiotics. 2021; 10(12):1531. https://doi.org/10.3390/antibiotics10121531

Chicago/Turabian Style

Borek, Aleksandra J., Katherine Maitland, Monsey McLeod, Anne Campbell, Benedict Hayhoe, Christopher C. Butler, Liz Morrell, Laurence S.J. Roope, Alison Holmes, Ann S. Walker, Sarah Tonkin-Crine, and on behalf of the STEP-UP Study Team. 2021. "Impact of the COVID-19 Pandemic on Community Antibiotic Prescribing and Stewardship: A Qualitative Interview Study with General Practitioners in England" Antibiotics 10, no. 12: 1531. https://doi.org/10.3390/antibiotics10121531

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