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Antibiotic prescribing in residential aged care facilities — health care providers’ perspectives

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To the Editor: I was interested to gain some insight into the drivers of antibiotic prescribing in Australian residential aged care facilities (RACFs).1 I was surprised, though, that Lim and colleagues did not include residents or their families in consultations, opting to focus solely on the perspectives of health care providers.

It is apparent that consumers have a key role to play in antimicrobial stewardship initiatives;2 expectations of consumers are often identified by clinicians as a contributing factor in inappropriate antimicrobial prescribing in primary care. It should not have come as a surprise that the impact of patients and their families emerged as a recurring theme in responses from general practitioners and nurses in the study (see Box 4), with the discussion citing pressure from family as having a “significant influence”.1 It has been shown, however, that it is not only patients’ views, but clinicians’ perceptions of these views, that influence prescribing decisions.35

Recommendations made in the discussion to overcome the impact of patient or family pressures are at risk of being ineffective in the absence of consumer consultation. Recognition of these limitations, and comment on opportunities…