RATIONAL USE OF ANTIBIOTICS IN PRIMARY HEALTH CARE AND ITS RELATIONSHIP WITH BACTERIAL RESISTANCE: CLINICAL CHALLENGES AND CONTROL STRATEGIES
DOI:
https://doi.org/10.63330/aurumpub.061-028Keywords:
Antibiotics, Antimicrobial stewardship, Bacterial resistance, Primary Health Care, Rational use of medicinesAbstract
The rational use of antibiotics in Primary Health Care (PHC) is an essential strategy for addressing bacterial resistance, recognized as one of the most significant contemporary public health challenges. This study aimed to analyze, through an integrative literature review, the scientific evidence on antibiotic use in PHC and its relationship with bacterial resistance, highlighting clinical challenges and control strategies. The guiding question investigated available evidence on the rational use of antibiotics in PHC and its contribution to the development of bacterial resistance. Databases consulted included the Scientific Electronic Library Online (SciELO), PubMed/MEDLINE, Scopus, and SpringerLink, as well as international publishing platforms such as ScienceDirect (Elsevier), Wiley Online Library, Frontiers, and Taylor & Francis. Studies published between 2021 and 2026 in Portuguese and English were included. The results show that inappropriate antibiotic use is influenced by diagnostic uncertainty, patient pressure, structural limitations, and variability in clinical practice. A strong association was observed between inappropriate prescribing and the emergence of resistant microorganisms. Key strategies include antimicrobial stewardship, health education, and multidisciplinary approaches, although their implementation remains limited in several contexts. It is concluded that addressing bacterial resistance requires an integrated, evidence-based approach and strengthened health policies within PHC.
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