{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T17:10:03Z","timestamp":1783098603588,"version":"3.54.6"},"reference-count":27,"publisher":"University of Toronto Press Inc. (UTPress)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of the Association of Medical Microbiology and Infectious Disease Canada"],"published-print":{"date-parts":[[2023,11,29]]},"abstract":"<jats:sec><jats:title>Background:<\/jats:title><jats:p> Antimicrobial resistance is a worldwide phenomenon that leads to a significant number of unnecessary deaths and costly hospital admissions. More than 90% of antibiotic use happens in the community and of this, family physicians account for two-thirds of these prescriptions. Our study aims to determine whether family medicine residents are optimally trained in antibiotic prescribing for common infectious conditions seen in a primary care setting. <\/jats:p><\/jats:sec><jats:sec><jats:title>Methods:<\/jats:title><jats:p> This study is a secondary analysis of a prior study of antimicrobial stewardship in two urban primary care clinics in central Toronto, Ontario. A total of 1099 adult patient visits were included that involved family medicine resident trainees, seen between 2015 and 2016. The main outcome measures were resident antibiotic prescription rates for each condition and expert-recommended prescribing practices, the rate prescriptions were issued as delayed prescriptions, and the use of first-line recommended narrow-spectrum antibiotics. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p> Compared to expert-recommended prescribing rates, family medicine residents overprescribed for uncomplicated upper respiratory tract infections (URI) (5.0% [95% CI 2.2% to 9.7%] versus 0% expert recommended) and sinusitis (44.2% [95% CI 32.8% to 55.9%] versus 11%\u201318% expert range), and under prescribed for pneumonia (53.5% [95% CI 37.7% to 68.8%] versus 100% expert range]). Prescribing rates were within expert recommended ranges for pharyngitis (28.6% [95% CI 16.6% to 43.3%]), bronchitis (3.6% [95% CI 0% to 18.4%]), and cystitis (79.4% [95% CI 70.6% to 86.6%]). <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions:<\/jats:title><jats:p> The antibiotic prescribing practices of family medicine residents during their training programs indicated overprescribing of antibiotics for some common infection presentations. Further study of antibiotic prescribing in primary care training programs across Canada is recommended to determine if future family physicians are learning appropriate antibiotic prescribing practices. <\/jats:p><\/jats:sec>","DOI":"10.3138\/jammi-2022-0042","type":"journal-article","created":{"date-parts":[[2023,8,22]],"date-time":"2023-08-22T21:12:48Z","timestamp":1692738768000},"page":"192-200","source":"Crossref","is-referenced-by-count":1,"title":["Do family medicine residents optimally prescribe antibiotics for common infectious conditions seen in a primary care setting?"],"prefix":"10.3138","volume":"8","author":[{"given":"Bernard","family":"Ho","sequence":"first","affiliation":[{"name":"Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada"},{"name":"Ray D. Wolfe Department of Family Medicine, Sinai Health System, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sahana","family":"Kukan","sequence":"additional","affiliation":[{"name":"Ray D. Wolfe Department of Family Medicine, Sinai Health System, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Warren","family":"McIsaac","sequence":"additional","affiliation":[{"name":"Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada"},{"name":"Ray D. Wolfe Department of Family Medicine, Sinai Health System, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1696","reference":[{"issue":"10325","key":"r1","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1016\/S0140-6736(21)02724-0","volume":"399","author":"Murray CJ","year":"2022","journal-title":"Lancet"},{"key":"r2","unstructured":"Review on Antimicrobial Resistance (London). Grande-Bretagne. Antimicrobial Resistance: Tackling a Crisis for the Health and Wealth of Nations: December 2014. Review on Antimicrobial Resistance; 2014. https:\/\/amr-review.org\/sites\/default\/files\/AMR%20Review%20Paper%20-%20Tackling%20a%20crisis%20for%20the%20health%20and%20wealth%20of%20nations_1.pdf. (Accessed January 6, 2020)."},{"key":"r3","unstructured":"Government of Canada. Human Antimicrobial Use Report, 2012\/13. Public Health Agency of Canada, Guelph, Ontario; 2014. https:\/\/www.canada.ca\/en\/public-health\/services\/publications\/drugs-health-products\/human-antimicrobial-use-report-2014.html. (Accessed January 6, 2020)."},{"key":"r4","unstructured":"Canadian Antimicrobial Resistance Surveillance System - Report 2016. Public Health Agency of Canada, Guelph, Ontario; 2019. https:\/\/www.canada.ca\/en\/public-health\/services\/publications\/drugs-health-products\/canadian-antimicrobial-resistance-surveillance-system-report-2016.html. (Accessed January 24, 2020)."},{"issue":"9","key":"r5","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1542\/hpeds.2017-0059","volume":"7","author":"Shukla PJ","year":"2017","journal-title":"Hosp Pediatr"},{"issue":"1","key":"r6","doi-asserted-by":"crossref","first-page":"1","DOI":"10.14745\/ccdr.v46i01a01","volume":"46","author":"Leis JA","year":"2020","journal-title":"Can Commun Dis Rep"},{"issue":"13","key":"r7","doi-asserted-by":"crossref","first-page":"E726","DOI":"10.1503\/cmaj.120568","volume":"184","author":"L\u00e9gar\u00e9 F","year":"2012","journal-title":"CMAJ"},{"issue":"2","key":"r8","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1093\/fampra\/cmw144","volume":"34","author":"Dallas A","year":"2017","journal-title":"Fam Pract"},{"issue":"626","key":"r9","doi-asserted-by":"crossref","first-page":"e561","DOI":"10.3399\/bjgp14X681373","volume":"64","author":"Dallas A","year":"2014","journal-title":"Br J Gen Pract"},{"issue":"6","key":"r10","doi-asserted-by":"crossref","first-page":"805","DOI":"10.1007\/s11096-010-9441-6","volume":"32","author":"Bj\u00f6rnsd\u00f3ttir I","year":"2010","journal-title":"Pharm World Sci"},{"issue":"1","key":"r11","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1093\/fampra\/19.1.12","volume":"19","author":"Zwar N","year":"2002","journal-title":"Fam Pract"},{"key":"r12","doi-asserted-by":"publisher","DOI":"10.3138\/jammi-2020-0021"},{"key":"r13","doi-asserted-by":"crossref","first-page":"ii11","DOI":"10.1093\/jac\/dkx503","volume":"73","author":"Smith DR","year":"2018","journal-title":"J Antimicrob Chemother"},{"key":"r14","doi-asserted-by":"publisher","DOI":"10.3138\/jammi.2019-0023"},{"issue":"9","key":"r15","first-page":"CD004417","volume":"9","author":"Spurling GK","year":"2017","journal-title":"Cochrane Database Syst Rev"},{"issue":"1","key":"r16","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1186\/1710-1492-7-2","volume":"7","author":"Desrosiers M","year":"2011","journal-title":"All Asth Clin Immun"},{"issue":"1","key":"r17","doi-asserted-by":"crossref","first-page":"95S","DOI":"10.1378\/chest.129.1_suppl.95S","volume":"129","author":"Braman SS","year":"2006","journal-title":"Chest"},{"issue":"6","key":"r18","first-page":"CD000245","volume":"6","author":"Smith SM","year":"2017","journal-title":"Cochrane Database Syst Rev"},{"issue":"10","key":"r19","doi-asserted-by":"crossref","first-page":"e86","DOI":"10.1093\/cid\/cis629","volume":"55","author":"Shulman ST","year":"2012","journal-title":"Clin Infect Dis"},{"issue":"6","key":"r20","doi-asserted-by":"crossref","first-page":"425","DOI":"10.7326\/M15-1840","volume":"164","author":"Harris AM","year":"2016","journal-title":"Ann Intern Med"},{"issue":"8","key":"r21","doi-asserted-by":"crossref","first-page":"e72","DOI":"10.1093\/cid\/cis370","volume":"54","author":"Chow AW","year":"2012","journal-title":"Clin Infect Dis"},{"key":"r22","doi-asserted-by":"crossref","first-page":"S27","DOI":"10.1086\/511159","volume":"44","author":"Mandell LA","year":"2007","journal-title":"Clin Infect Dis"},{"issue":"5","key":"r23","doi-asserted-by":"crossref","first-page":"e103","DOI":"10.1093\/cid\/ciq257","volume":"52","author":"Gupta K","year":"2011","journal-title":"Clin Infect Dis"},{"key":"r24","unstructured":"SAS Institute Inc. SAS base software 9.4. 2013. Cary, NC, USA."},{"issue":"1","key":"r25","first-page":"31","volume":"4","author":"Walsh TL","year":"2020","journal-title":"Mayo Clinic Proceedings: Innovations, Quality & Outcomes"},{"issue":"7","key":"r26","doi-asserted-by":"crossref","first-page":"e008096","DOI":"10.1136\/bmjopen-2015-008096","volume":"5","author":"Tell D","year":"2015","journal-title":"BMJ Open"},{"issue":"626","key":"r27","doi-asserted-by":"crossref","first-page":"e561","DOI":"10.3399\/bjgp14X681373","volume":"64","author":"Dallas A","year":"2014","journal-title":"Br J Gen Pract"}],"container-title":["Journal of the Association of Medical Microbiology and Infectious Disease Canada"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/utppublishing.com\/doi\/pdf\/10.3138\/jammi-2022-0042","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,13]],"date-time":"2025-03-13T18:11:58Z","timestamp":1741889518000},"score":1,"resource":{"primary":{"URL":"https:\/\/utppublishing.com\/doi\/10.3138\/jammi-2022-0042"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,29]]},"references-count":27,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2023,11,29]]}},"alternative-id":["10.3138\/jammi-2022-0042"],"URL":"https:\/\/doi.org\/10.3138\/jammi-2022-0042","relation":{},"ISSN":["2371-0888","2371-0888"],"issn-type":[{"value":"2371-0888","type":"print"},{"value":"2371-0888","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,29]]}}}