Evidence-based strategies for better antibiotic prescribing

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.

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.

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.