To reduce the development of drug-resistant bacteria and maintain the effectiveness of antibiotics and other antibacterial drugs, antibiotics should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria.

When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy.

Prescribing antibiotics in the absence of a proven or strongly suspected bacterial infection or a prophylactic indication is unlikely to provide benefit to the patient and increases the risk of the development of drug-resistant bacteria.

Antibiotic Prescribing Recommendations

It is important to prescribe antibiotics only when they are necessary, and not for self-limiting mild respiratory infections such as colds and most coughs, sinusitis, earache and sore throats.

When prescribing antimicrobials, prescribers should follow national guidelines on:

• prescribing the shortest effective course
• the most appropriate dose
• route of administration.

The Advisory Committee on Antimicrobial Prescribing, Resistance advises that:

·        When antimicrobials are necessary to treat an infection that is not life-threatening, a narrow-spectrum antibiotic should generally be first choice.

·        For infections that are not life-threatening, broad-spectrum antibiotics (for example, cephalosporins (cefuroxime/clavulanate), amoxicillin/clavulanate and quinolones) need to be reserved for second-choice treatment when narrow-spectrum antibiotics are ineffective.

·        If immediate antibiotic treatment is necessary, the clinical diagnosis and continuing need for antibiotics should be reviewed within 48 to 72 hours.

·        For patients who have suspected and recurrent or persistent infections, take microbiological samples/Culture & Sensitivity (C/S) test before prescribing an antimicrobial and review the prescription when the results are available.

·        Do not issue an immediate prescription for an antimicrobial to a patient who is likely to have a self‑limiting condition.

·        Avoid issuing repeat prescriptions for longer than 6 months without review and ensure adequate monitoring for individual patients to reduce adverse drug reactions and to check whether continuing an antimicrobial is really needed.

Indiscriminate use of broad-spectrum antibiotics creates a selective advantage for bacteria resistant even to these 'last-line' broad-spectrum agents, and also kills normal commensal flora leaving people susceptible to antibiotic-resistant harmful bacteria such as Clostridium difficile (C. difficile).

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