It’s one thing to read a guideline; it’s another to apply it when a patient is pushing for an immediate fix. Antibiotic stewardship remains one of the most persistent challenges in primary and urgent care, and it often comes down to one key factor: patient education.
From explaining viral vs. bacterial infections to setting clear expectations for symptom management, conversations in the exam room play a critical role in reducing unnecessary prescribing. But with limited time and increasing patient demands, getting that balance right isn’t always simple.
On Healthcasts, clinicians across specialties share how they prioritize patient education, manage symptoms effectively, and use tools to support their approach.
How are you approaching antibiotic stewardship in your practice? Log in or sign up to read the full post, leave a comment, and see the Consensus.
Key takeaways about tools for preventing the overuse of antibiotics:
Family Practice
"I currently work in an urgent care, and I will say our prescribing rates are low. However, many of us pride ourselves on treatment based on evidence-based medicine. Explaining to patients the differences between viruses and bacteria, and when to return for a possible bacterial infection. More recently, our organization has created an incentivized metric regarding antibiotic prescribing. The CDC also has a great chart that we have placed in patient rooms that provides a list of conditions, whether they are viral or bacterial, and whether or not antibiotics are needed."
Infectious Disease/HIV
"Detailed patient discussion including risks of unnecessary antibiotic use, usually rapid/POCT screening results, and also occasional delayed prescription writing."
Internal Medicine
"I explain to patients when symptoms are viral and give clear guidance on supportive care, aka recommend specific OTC meds to manage symptoms. I tell them to contact me if they are not improving in a certain time frame (based on how long they have already had symptoms), and then I can prescribe an antibiotic. They usually never contact me.
I have been seeing a lot of post-viral cough, lingering weeks or sometimes a month, for which I do usually prescribe prednisone."
Nurse Practitioner
"Using evidence-based guidelines for common conditions helps guide when antibiotics are truly indicated, while POC testing can provide reassurance when infections are viral. Equally important is how we communicate.
Offering patients a clear explanation, a concrete symptom management plan, and specific follow-up instructions. When patients feel heard and have a plan, they’re much more comfortable avoiding antibiotics when they’re not needed."
Internal Medicine
"Education is everything! Most infections are viral and, as such, not treatable by antibiotics. Furthermore, I explain to my patient significant complications with use, such as renal failure or C. diff. After that discussion, they have no problem with not getting antibiotics. The problem is that this takes time—time we don't have."
Family Practice
"As patients often expect a prescription for something they can't get OTC (especially if paying out of pocket), I often provide Tessalon Perles and Atrovent nasal spray for symptomatic relief. I also don't prescribe antibiotics without a face-to-face office visit."
Internal Medicine
"I have my triage nurses ask about Flu and COVID testing (and have them do it at home). If negative, then OTC cold medications, rest, and fluids are needed for at least the first 7-10 days of symptoms. For patients who have symptoms lasting more than this time period and have documented negative viral testing, then I think antibiotics may be warranted."
Family Practice
"A good assessment goes a long way, assess for fever, increase heart rate, use swabs and labs to determine immediate needs for antibiotics. Try to explain to the patient the need to hold off on antibiotics until the actual infection is confirmed, unless clinically needed."
Family Practice
"Patient education on bacterial vs viral. I have also started framing as it’s a positive that it’s likely viral, i.e., saying 'good news, I don’t think you need an antibiotic at this time' and giving them strict return precautions for worsening symptoms."
Family Practice
"Education is the best tool, but many times there isn’t adequate time. I have also found that setting them up with an excellent regimen for their symptoms that truly works helps them to believe me, and they are less likely to expect antibiotics once they experience what a great symptomatic regimen can do!!!"
What strategies have you found to be successful for educating patients about antibiotics? Share your approach and read all of the comments on the post on Healthcasts.