Optimising antibiotic prescribing in primary care

Prudent antimicrobial prescribing in the community may help to prevent the relentless increase in resistance, highlighted worldwide by numerous parliamentary documents. Antibiotic guidance, developed by primary care professionals and disseminated locally with outreach workshops, helps to reduce the use of broad-spectrum antimicrobials. Computerised guidance, audit of antibiotic use and restricted laboratory sensitivity reporting moves the prescriber towards the selection of recommended drugs. Educational campaigns and patient leaflets given at the consultation help to modify patients' expectations. Primary care physicians need to consider how much pharmaceutical representatives and free samples influence their prescribing. This multi-faceted approach needs to be backed up with a research programme developing the evidence base for management guidance of antimicrobial use in primary care.