Baclet N, et al. – Authors systematically reviewed explicit definitions of antibiotic–potentially inappropriate prescriptions (PIPs) used in studies of older adults. 62 explicit definitions of antibiotic–PIPs were identified. Most of the definitions were not found in more than one study, and they varied in the degree of precision. It seems that a consensus on explicit definitions of PIPs of antibiotic might help to reduce inappropriate prescriptions of antibiotics and to fight against antimicrobial resistance.

Methods

• The MEDLINE, Scopus and Web of Science core collection databases were searched; a combination of three terms and their synonyms were used: “potentially inappropriate prescription” AND “antibiotic treatment” AND “older patients”.
• After the standardized selection of publications, researchers extracted explicit definitions of antibiotic-PIPs and classified them into infectious disease domains and sub-domains.

Results

• In this study, a total of 600 search queries identified 4,270 records; 93 were selected for review.
• Findings revealed 160 mentions of antibiotic-PIPs, corresponding to 62 distinct definitions in 19 infectious disease domains.
• About half of the definitions were concerning upper respiratory tract infections (n=11 definitions; 17.7%), lower respiratory tract infections (n=8; 12.9%) and drug-drug interactions (n=11; 17.7%).
• Almost 75% of the definitions (n=46) were mentioned in a single study only.
• Only three definitions were identified that were related to critically important antibiotics, such as third-generation cephalosporins and fluoroquinolones.