# Educational Technologies to Support Rational Antimicrobial Prescribing in Primary Healthcare: A Systematic Review

## TL;DR

This paper reviews how educational tools can help healthcare providers prescribe antibiotics more responsibly, aiming to reduce antimicrobial resistance.

## Contribution

The study systematically evaluates the effectiveness of educational technologies in promoting rational antimicrobial prescribing in primary healthcare.

## Key findings

- Seven studies showed educational technologies like workshops and online courses may support better antimicrobial prescribing.
- Most studies had a high risk of bias, limiting the strength of the evidence.
- Multifaceted interventions were commonly used but lacked methodological rigor.

## Abstract

Background: Antimicrobial resistance is a global public health challenge that compromises patient safety and has gained particular relevance in primary healthcare, where the prescription of antimicrobials is frequent and often based on empirical knowledge. In this context, educational technologies emerge as strategies to strengthen professional training and promote rational antimicrobial use. Methods: A systematic review of randomized controlled trials was conducted, registered in PROSPERO (CRD42024504630) and guided by the PICOS framework. The search was carried out in 14 national and international databases, including PubMed/MEDLINE, Embase, Cochrane Library, SCOPUS, and LILACS, with no restrictions on language or publication year. Results: A total of 763 studies were identified, of which seven met the inclusion criteria and were included in the qualitative synthesis. The educational technologies reported comprised booklets, interactive seminars, workshops, training programs, online courses, and multifaceted interventions. Inter-rater agreement was substantial (κ = 0.823), although 85.7% of the studies presented a high risk of bias, mainly related to deviations from intended interventions. Conclusions: Educational technologies show potential to support appropriate antimicrobial prescribing and represent valuable tools in preventing antimicrobial resistance, although current evidence remains limited by methodological weaknesses.