Background: Knowledge, perceptions and prescribing behaviour are key to antibiotic prescribing. The aim of this paper is to systematically review this. Method: An extensive literature search from 1990-2014. Results: 19 articles were included; 8 in ambulatory care, 7 in hospital settings, and 4 in both, across all countries. Physicians still have inadequate knowledge and misconceptions about antibiotic prescribing. Moreover, some physicians although aware that antibiotics are of limited benefit in some conditions still prescribed them. Several factors influenced prescribing including patients' expectations, severity and duration of infections, uncertainty over diagnosis, potentially losing patients, and influence of pharmaceutical companies. Pocket-sized guidelines seen as an important source of information for physicians. Conclusion: Inadequate knowledge of prescribing is prevalent among physicians. However, many physicians were interested in improving their antibiotic prescribing. Multifaceted interventions targeting all key stakeholders including patients are needed to improve future antibiotic prescribing.

Introduction and aims: It is necessary to ascertain current prescribing of antibiotics for upper respiratory tract infections (URTIs) to address potential overuse. A retrospective analysis was conducted of all prescriptions for URTIs among ten public primary healthcare centres in Kedah, Malaysia from 1 st January to 31 st March 2014. Results: A total of 123,524 prescriptions were screened and analysed. Of these, 7129 prescriptions were for URTI, with 31.8% (n=2269) containing antibiotics. Macrolides were the most commonly prescribed antibiotic constituting 61% (n=1403) of total antibiotics prescribed. There was a statistically significant association between different prescribers and diagnoses (p=0·001) and a weak positive trend suggesting family medicine specialists are more competent in antibiotic prescribing, followed by medical officers and assistant medical officers (τ=0·122).. Conclusions: Prescribing practices of some prescribers were inconsistent with current guidelines encouraging resistance development. National antimicrobial stewardship programmes and further educational initiatives are ongoing in Malaysia to improve antibiotic use

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