1 Exploring the implementation of interventions to reduce antibiotic use (ENACT study)

While a number of interventions to optimise antibiotic prescribing in primary care exist, it remains unclear which influences on prescribing behaviour they target, how well, and how these interventions could be improved to further optimise antibiotic use. This project builds on previous research on the behavioural content of nationally implemented antimicrobial stewardship (AMS) interventions (1). It aimed to identify (a) influences on antibiotic prescribing decisions (and barriers and facilitators to appropriate antibiotic prescribing), (b) evidence for which research interventions are effective in reducing antibiotic prescribing or use for acute respiratory tract infections (RTIs), and (c) intervention components that may help optimise nationally implemented AMS interventions. The overall aim was to develop recommendations on how AMS interventions could be improved for professionals whose roles involve promoting AMS (for example, from Public Health England, commissioning groups, primary care organisations) and for designers, owners and users of current AMS interventions. The project focused on primary care settings including: general practice, out-of-hours (OOH), walk-in or urgent care centres, and community pharmacy.