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Better, not just fewer: Rethinking antibiotic prescribing
Giorgia Sulis1,2, Derek R MacFadden1,3
1School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
Plos Medicine
|February 27, 2026
Summary
Clinical decision support tools can reduce unnecessary antibiotic prescriptions. Addressing behavioral, equity, and governance issues is crucial for tackling antimicrobial resistance and promoting "better, not just fewer" antibiotic uses.
Area of Science:
- Public Health
- Infectious Diseases
- Health Informatics
Background:
- Antimicrobial resistance (AMR) is a significant global health threat.
- Clinical decision support (CDS) tools can help optimize antibiotic prescribing.
- Technological solutions alone are insufficient to curb unnecessary antibiotic use.
Purpose of the Study:
- To explore the multifaceted challenges in combating antimicrobial resistance.
- To highlight the importance of behavioral, equity, and governance factors.
- To advocate for a "better, not just fewer" approach to antibiotic prescribing.
Main Methods:
- Review of existing literature on CDS tools and AMR.
- Analysis of behavioral, equity, and governance barriers.
- Synthesis of evidence to support a comprehensive strategy.
Main Results:
- Success of CDS tools is contingent upon addressing non-technical factors.
- Behavioral patterns significantly influence prescribing habits.
- Equity considerations are vital for effective AMR interventions.
- Robust governance frameworks are necessary for sustainable antibiotic stewardship.
Conclusions:
- A holistic approach integrating technology with behavioral, equity, and governance strategies is essential for effective antimicrobial resistance containment.
- Focusing on "better, not just fewer" antibiotic prescriptions ensures optimal patient outcomes and preserves antibiotic efficacy.
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