Evidence-based strategies for better antibiotic prescribing

BACKGROUND: Antibiotic resistance is a key global health threat, and antibiotic overuse is a significant contributing factor. Antibiotic stewardship is a vital issue for general practice. 

OBJECTIVE: The aim of this article is to discuss evidence-based strategies for general practitioners (GPs) and general practices to contribute to antibiotic stewardship and, thus, reduce the overall burden of antibiotic prescribing in the community. 

DISCUSSION: For individual GPs, and for practices, there is good evidence for the effectiveness of several strategies. As well as having a firm grasp of the clinical evidence in the area, important strategies for GPs include: eliciting and exploring patient understanding and expectations, and incorporating these in communication and management; offering delayed prescribing; using appropriate non-antibiotic symptomatic management; and, when prescribing antibiotics, doing so only for genuine clinical indications, with the appropriate antibiotic, at the appropriate dose, for the shortest appropriate duration. Practices can adopt a practice culture and practice-wide prescribing policies that promote antibiotic stewardship.