PEBC MCQ Public Health & Stewardship question: reduce unnecessary antibiotic use for adults with probable viral upper respiratory

PEBC MCQPublic Health & Stewardship

A prescriber asks the pharmacist how to reduce unnecessary antibiotic use for adults with probable viral upper respiratory infections in her practice. Which strategy is best supported?

a. Symptom care advice, with delayed prescriptions where suitable
b. Prescribing a narrow-spectrum antibiotic such as amoxicillin instead of azithromycin
c. Giving patients written information on antibiotic resistance only
d. Ordering a throat swab or chest x-ray for every patient before deciding

Show the answer and explanation

Answer: a. Symptom care advice, with delayed prescriptions where suitable

Stewardship interventions with evidence in primary care include communication about the viral nature of infections, symptomatic management advice, delayed ('wait-and-see') prescriptions and audit and feedback. A narrower antibiotic is still unnecessary for a viral illness, leaflets alone change little, and routine testing for every patient adds cost without reducing prescribing. Choosing Wisely Canada's 'Using Antibiotics Wisely' campaign supports these approaches. Source: Choosing Wisely Canada, Using Antibiotics Wisely campaign (2023); Public Health Agency of Canada, Pan-Canadian Action Plan on Antimicrobial Resistance (2023).

Common mistake

Thinking broad-spectrum antibiotics prevent complications of viral infections.

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