Grant: JPIAMR Network Plus

Antibiotic overuse is an important contributor to antimicrobial resistance. Over 90% of antibiotic use is in the community, with estimates of unnecessary use ranging from 25%-50%. Audit and feedback (A&F) can be effective in improving prescribing behaviour. Jurisdictions implementing community antibiotic A&F programs will benefit from tools and resources to optimize effectiveness. Research that builds on existing knowledge to advance the field of A&F is needed. Important questions remain surrounding the optimal data to use and methods of data delivery to clinicians, tools to incorporate data into practice, and ensure sustainability over time. We propose assembling an international network of antimicrobial stewardship, primary care, and implementation science (with A&F expertise) experts, which will bring diversity in expertise, geographical locations, career stages, and genders. The network will be coordinated by three co-leads; antimicrobial stewardship (Schwartz), primary care (Lindbeak), and implementation science (Ivers). With overall objectives to provide best practice resources on conducting A&F interventions on antibiotic use in primary care and define research priorities to advance this field. We will employ a modified Delphi method to solicit input, while minimizing bias, from subgroups of experts via video conferencing and 2 multi-day in-person meetings over two years. There is also a contingency plan to host virtual meetings due to COVID-19 pandemic restrictions. We will leverage existing international collaboration with the A&F MetaLab, to facilitate ongoing knowledge translation. Multiple outputs from this network, including a systematic review, best practice resources and toolkits, and a paper outlining research priorities, will be organized into publishable peer-reviewed manuscripts as part of a broader dissemination and knowledge translation plan that leverages existing stakeholder networks among this diverse network.