Strategies to promote prudent antibiotic use: exploring the views of professionals who develop and implement guidelines and interventions.

BACKGROUND A variety of interventions have been developed to promote prudent antibiotic use, especially for respiratory tract infections (RTIs); however, it is not yet clear which are most acceptable and feasible for implementation across a wide range of contexts. This study elicited the views of experts, professionals who develop and implement guidelines and interventions, from five countries, on the development of RTI guidelines and interventions for implementing them. OBJECTIVES The aim was to determine whether there are common features of interventions which experts consider useful in changing health professionals' behaviour, or whether there are important contextual differences in views. METHODS Fifty semi-structured interviews explored experts' views and experiences of strategies across five countries. Interviews were carried out in person or over the phone, transcribed verbatim and translated into English, if not already in English, for analysis. RESULTS Themes were remarkably consistent across the countries, and these could be summarized as five sets of recommendations: guidelines should be developed by health care professionals to better fit GPs' needs; address GP concerns about recommendations and explain the need for guidelines; design flexible interventions to increase feasibility across primary care practice; provide interventions which engage GPs; and provide consistent messages about antibiotic use for patients, professionals and the public. CONCLUSIONS Key features need to be addressed when developing future guidelines and interventions in order to improve their implementation. Consistency in experts' views across countries indicates the potential for the development of interventions which could be implemented on a multinational scale with widespread support from key opinion leaders.