How can general practitioners reduce antibiotic prescribing in collaboration with their patients?

Most antibiotics prescribed in primary care are for acute, and often self-limiting, conditions. Patients' expectations of needing antibiotics are an influential driver of general practitioners' (GPs') prescribing behaviour. Better managing patient expectations in consultations for acute infections may be important for reducing prescribing, particularly for self-limiting conditions.

The aim of this article is to increase awareness about patients' beliefs and expectations about antibiotics for acute conditions and provide strategies and resources that GPs can use in collaboration with their patients for managing these expectations.

Expectations of antibiotics may reflect a desire for symptomatic treatment, lack of awareness of other options or previous experience. Consultations for many acute conditions are particularly suited to shared decision making - it enables discussion about expectations and antibiotic benefits and harms and assists patients to make an informed decision. Delayed prescribing is another evidence-based strategy that can be used as part of shared decision making.