Turning the tide on resistance: lessons from primary care
Antibiotic stewardship in Australian primary care requires practical, sustained strategies rather than short-term efforts. This review identifies delayed prescribing as the most effective consultation-based approach, reducing antibiotic use by 64% while maintaining patient safety and improving communication during consultations. Audit and feedback interventions, such as peer-comparison letters to high prescribers, achieved an additional 8–9% reduction across general practice but remain underused, with only a small proportion of GPs routinely engaging in such programs. These findings highlight the need for broader implementation and long-term investment in strategies that have proven to reduce prescribing in real-world settings. Strengthening national coordination, education, and feedback systems will help embed evidence-based stewardship approaches into daily practice, achieving sustained reductions in unnecessary antibiotic use and preserving antibiotic effectiveness for future generations.
Reducing antibiotic overuse – one consultation at a time
Antibiotic resistance is a growing global threat, and general practice remains its front line – where most antibiotics are prescribed, often unnecessarily. In Australia, prescribing rates for acute respiratory infections are four to nine times higher than guideline recommendations, despite minimal clinical benefit in most cases. A key message from this article is that antibiotics are not the “safe default”; they can cause harm, reinforce unnecessary expectations, and undermine self-management for self-limiting infections. This study emphasises that communication, reassurance, and safety-netting are central to reducing overprescribing, as many GPs overestimate patient expectations for antibiotics. Yet uptake of these evidence-based approaches remains inconsistent, often constrained by diagnostic uncertainty, time pressure, and entrenched practice culture. Strengthening communication skills, normalising symptomatic care, and embedding practice-wide AMS messaging can produce sustained reductions in unnecessary antibiotic use and foster more confident, evidence-based prescribing across Australian primary care. Read more