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Implications for practice and research
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Public health campaigns can reduce antibiotic prescribing, although the effect is likely to be mediated primarily through changes in clinician behaviour rather than patient-consulting behaviour or expectations for antibiotics.
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More research is needed on the key components of antimicrobial stewardship activities: the effects on antimicrobial resistance, the cost-effectiveness and the sustainability of effect.
Context
Antimicrobial resistance (AMR) is an important and growing international health threat.1 Exposure to antibiotics is the primary driver of AMR; therefore, efforts to tackle this problem commonly focus on reducing unnecessary prescribing. Most antibiotic prescribing occurs in primary care, and the majority of prescribing is for respiratory tract …