Identification of cultural determinants of antibiotic use cited in primary care in Europe: a mixed research synthesis study of integrated design "Culture is all around us".

摘要: Inappropriate antibiotic prescribing, particularly for respiratory tract infections (RTI) in ambulatory care, has become a worldwide public health threat due to resulting resistance. In spite of various interventions and campaigns, wide variations use persist between European countries. Cultural determinants are often referred as potential cause, but rarely defined. To our knowledge, so far no systematic literature review focused on cultural use. The aim this study was identify determinants, country-specific level care Europe, describe the influence culture use, using framework dimensions. A computer-based conducted by two research teams, France Norway. Eligible publications included studies exploring primary at least countries based results, featuring description published 1997 2015. Quality assessment independently researchers, one each team, appropriate checklists according design. Each paper characterized method, involved, sampling main mentioned selected were extracted, described categorized. Finally, Hofstede’s dimensions associated with consumption within setting described. Among 24 eligible papers, 11 rejected exclusion criteria. Overall, 13 papers meeting quality criteria included, which used quantitative methods qualitative or mixed methods. participants patients (nine studies) general practitioners (two studies). This identified either patient-related (illness perception/behaviour, health-seeking behaviour, previous experience, awareness, drug perception, diagnosis labelling, work ethos, perception practitioner) practitioner-related (RTI management, initial training, legal issues, practice context) both (antibiotic awareness). factors should be considered exerting an ubiquitous all consecutive stages disease process seem closely linked education. Interactions determinant categories, multiple, complex require further investigation overlapping disciplines. context projects seems relevant.