The majority of antibiotic prescriptions in Australia are written in primary care. Educational interventions have had limited success at improving prescribing practice. Primary care clinicians are in the difficult position of trying to balance best practice against patient satisfaction.

A group of Australian GP registrars were involved in discussions to determine the barriers to appropriate antibiotic prescribing in their practice. Registrars were aware that antibiotics were not recommended for upper respiratory tract infections but still prescribed them as part of their practice. Registrars noted that it was easier to ‘give in’ to prescribing antibiotics. There was concern regarding patient safety and subsequent hospital admissions if antibiotics were not provided. Concerns regarding diagnostic certainty lead to more antibiotic prescriptions although registrars did note that the use of the Therapeutic Guidelines provided reassurance of appropriate prescribing practice.

Supervisor influence was identified as an important factor in antibiotic prescribing. Supervisors who supported registrars in not prescribing antibiotics and provided education on dealing with patients regarding antibiotic use were contrasted with those who prescribed outside of best practice guidelines.

Intervention and education in the early stages of training along with mentoring represent an important initiative in reducing inappropriate antibiotic prescriptions in primary care.

Full text of the article is available http://bjgp.org/content/64/626/e561