Prescriber-led practice changes that can bolster antimicrobial stewardship in community health care settings

Stabilizing the emerging resistance of antibiotics depends on our ability to practise appropriate antimicrobial stewardship (AMS). Over 90% of antibiotics dispensed for human use are prescribed in community health care settings rather than in hospitals, with the main prescribers being family physicians, dentists, pharmacists and nurse practitioners working across a broad range of private offices, family health teams, urgent care clinics, emergency departments and long-term care homes. To improve the reach of AMS in community health care settings, the Public Health Agency of Canada partnered with Choosing Wisely Canada in 2017 to develop a focused campaign titled Using Antibiotics Wisely. This campaign is led by the prescribers of antibiotics themselves, who work in community health care settings and are better equipped to identify the specific changes that would support more appropriate use of antibiotics. This article describes these practice changes, the strengths and challenges of Using Antibiotics Wisely and future opportunities to further advance AMS across community health care settings.