Regional and national antimicrobial stewardship activities:a survey from the Joint Programming Initiative on Antimicrobial Resistance - Primary Care Antibiotic Audit and Feedback Network (JPIAMR-PAAN)

Expectations of how theory, empirical material, and methods should be dealt with in academic writing has not always been explicitly communicated to students. Due to a heterogeneity in student populations enrolled in higher degree courses worldwide, diversity in academic writing practices has increased. This paper explores academic writing practices among a group of students with professional, vocational backgrounds and close relationships to practical knowledge. Twelve examination papers from fifteen students within a continuing education program at a Danish university have been analysed inspired by Aristotle’s activities of theoria and praxis and Bourdieu’s concept of strategy. In this perspective, the study shows student strategies of how the students seem to retain an affinity to allow a practical approach of social and ethical evaluation when handling theory, empirical material, and methods. The analysis shows that students’ personal preferences are brought into the foreground. Background: Antibiotic overuse and misuse in primary care are common, highlighting the importance of antimicrobial stewardship (AMS) efforts in this setting. Audit and feedback (A&F) interventions can improve professional practice and performance in some settings. Objectives and methods: To leverage the expertise from international members of the Joint Programming Initiative on Antimicrobial Resistance - Primary care Antibiotic Audit and feedback Network (JPIAMR-PAAN). Network members all have experience of designing and delivering A&F interventions to reduce inappropriate antibiotic prescribing in primary care settings. We aim to introduce the network and explore ongoing A&F activities in member regions. An online survey was administered to all network members to collect regional information. Results: Fifteen respondents from 11 countries provided information on A&F activities in their country, and national/regional antibiotic stewardship programmes or policies. Most countries use electronic medical records as the primary data source, antibiotic appropriateness as the main outcome of feedback, and target GPs as the prescribers of interest. Funding sources varied across countries, which could influence the frequency and quality of A&F interventions. Nine out of 11 countries reported having a national antibiotic stewardship programme or policy, which aim to provide systematic support to ongoing AMS efforts and aid sustainability. Conclusions: The survey identified gaps and opportunities for AMS efforts that include A&F across member countries in Europe, Canada and Australia. JPIAMR-PAAN will continue to leverage its members to produce best practice resources and toolkits for antibiotic A&F interventions in primary care settings and identify research priorities.