HFHT's Choosing Wisely Newsletter
For the whole healthcare team.
Issue 65: Antibiotics Wisely
As we head into another season of viruses, it is important to remember good antibiotics stewardship. Mathematical modelling has shown that by the year 2050, if we continue as we are now, more people will die world-wide from antibiotic-resistant infections than cancer.
This is an introduction to the coming series of scenarios taken from Choosing Wisely Canada and their Using Antibiotics Wisely campaign.
Barriers to NOT prescribing antibiotics to patients with acute respiratory infections:

  • Knowledge
  • Skills
  • Beliefs
  • Inertia (changing practice is difficult)
  • Social influence
  • Time

Common Myths:

MYTH : All patients coming to the clinic with an URTI want antibiotics.

FACT: They want a diagnosis and a way to relieve their symptoms.

MYTH: All patients that are given a delayed prescription will go and fill it.

FACT: Only 1/3 of the prescriptions get filled.

JGIM 2003, Cochrane 2013, BMJ Open 2016
The tools developed by Choosing Wisely Canada will help:

  • To make patients aware of the problems of too much antibiotics.
  • To address patient’s concerns at the moment of the encounter.
  • To convince your colleagues.
  • To ease your own practice change.
  • To save time.

The Delayed Prescription and the Viral Prescription are downloadable in custom format for Telus, Oscar and Accuro directly from Choosing Wisely Canada .  
Don’t routinely prescribe antibiotics for acute respiratory illnesses in primary care

  • Otitis Media: vaccinated patients > 6 months
  • Pharyngitis: modified Centor score
  • Sinusitis: PODS symptoms
  • AECOPD: inhalers
  • Bronchitis/Asthma: inhalers
  • URTI: “common cold”
  • ILI: influenza like illness

In the following series of briefings, we will get to these common conditions and ways to reduce antibiotic usage.
Antibiotic stewardship is everyone’s responsibility.

Adapted from the slides provided by Choosing Wisely Canada .
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