Scoping review of variation in clinical guidelines for delivery of injectable long-acting penicillin across Australia and Aotearoa New Zealand.

Objective: This scoping review explores existing clinical guidelines on administration of benzathine benzylpenicillin (Bicillin L-A, Pfizer Australia) in Australia and Aotearoa New Zealand. The objective is to understand existing delivery guidance to address variation in care and cultural safety considerations, to support messaging during periods of stockout and to inform planning for new administration techniques.

Data sources: Semi-structured Google search to identify publicly available clinical resources for each jurisdiction of Australia and for New Zealand. The search was conducted from October to December 2023.

Design: Government reports and publicly available clinical guidelines were included. This scoping review is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR).

Results: This guideline review demonstrates that guidance on administration of Bicillin L-A in Australia and New Zealand has strong, consistent, biomedical recommendations but underdeveloped cultural considerations. Across the features of culturally safe practice, existing clinical guidelines provide consistent information on biomedical knowledge and skills, less information about practising culturally safe behaviours and relatively little guidance on addressing power differentials.

Conclusions: Cultural safety inclusions should be considered for future administration guidance development.