15 Dec 2025 Avoid antibiotics for self-limited viral infections
References
- Costelloe C, Metcalfe C, Lovering A, et al. Effect of antibiotic prescribing in primary care on antimicrobial resistance in individual patients: systematic review and meta-analysis. BMJ 2010; 340:c2096. DOI: 10.1136/bmj.c2096
- Bell BG, Schellevis F, Stobberingh E, et al. A systematic review and meta-analysis of the effects of antibiotic consumption on antibiotic resistance. BMC Infectious Diseases 2014; 14:13. DOI: 10.1186/1471-2334-14-13
- Fisher H, Oluboyede Y, Chadwick T, et al. Continuous low-dose antibiotic prophylaxis for adults with repeated urinary tract infections (AnTIC): a randomised, open-label trial. The Lancet Infectious Diseases 2018; 18(9):957–68. DOI: 10.1016/S1473-3099(18)30279-2
- Ivankovic M, Schwartz K. Shorter Courses of Antibiotics. CMAJ Canadian Medical Association Journal 2024; 196(37):E1266. DOI: 10.1503/cmaj.240246
- Sanden L, Paul M, Leibovici L, Andreassen S. Quantifying the associations between antibiotic exposure and resistance – a step towards personalised antibiograms. European Journal of Clinical Microbiology & Infectious Diseases 2016; 35(12):1989-96. DOI: 10.1007/s10096-016-2751-4
- Harbarth S, Harris AD, Carmeli Y, Samore MH. Parallel analysis of individual and aggregated data on antibiotic exposure and resistance in gram‐negative bacilli. Clinical Infectious Diseases 2001; 33(9):1462–8. DOI: 10.1086/322677
- Pouwels KB, Freeman R, Muller-Pebody B, et al. Association between use of different antibiotics and trimethoprim resistance: going beyond the obvious crude association. Journal of Antimicrobial Chemotherapy 2018; 73(6):1700-7. DOI: 10.1093/jac/dky031
- Saciuk Y, Nevo D, Chowers M, Obolski U. Penicillin allergy as an instrumental variable for estimating antibiotic effects on resistance. Nature communications 2025; 16(1):1088. DOI: 10.1038/s41467-025-56287-x
- Rahman S, Kesselheim AS, Hollis A. Persistence of resistance: a panel data analysis of the effect of antibiotic usage on the prevalence of resistance. Journal of Antibiotics 2023; 76(5):270-8. DOI: 10.1038/s41429-023-00601-6
- Anonymous. When Antibiotics Fail: The Expert Panel on the Potential Socio-Economic Impacts of Antimicrobial Resistance in Canada. Ottawa: Council of Canadian Academies 2019. https://cca-reports.ca/wp-content/uploads/2018/10/When-Antibiotics-Fail-1.pdf
- BC Centre for Disease Control. BCCDC Antimicrobial Utilization Dashboard. 2025. http://www.bccdc.ca/health-professionals/data-reports/antimicrobial-resistance-utilization/antimicrobial-utilization-dashboard
- Mamun AA, Saatchi A, Xie M, et al. Community Antibiotic Use at the Population Level During the SARS-CoV-2 Pandemic in British Columbia, Canada. Open Forum Infectious Diseases 2021; 8(6):ofab185. DOI: 10.1093/ofid/ofab185
- Fleming-Dutra KE, Hersh AL, Shapiro DJ, et al. Prevalence of Inappropriate Antibiotic Prescriptions Among US Ambulatory Care Visits, 2010-2011. JAMA 2016; 315(17):1864-73. DOI: 10.1001/jama.2016.4151
- Hersh AL, King LM, Shapiro DJ, et al. Unnecessary Antibiotic Prescribing in US Ambulatory Care Settings, 2010–2015. Clinical Infectious Diseases 2021; 72(1):133-7. DOI: 10.1093/cid/ciaa667
- Schwartz KL, Langford BJ, Daneman N, et al. Unnecessary antibiotic prescribing in a Canadian primary care setting: a descriptive analysis using routinely collected electronic medical record data. CMAJ open 2020; 8(2):E360-E369. DOI: 10.9778/cmajo.20190175
- Silverman M, Povitz M, Sontrop JM, et al. Antibiotic Prescribing for Nonbacterial Acute Upper Respiratory Infections in Elderly Persons. Annals of Internal Medicine 2017; 166(11):765–74. DOI: 10.7326/M16-1131
- Kitano T, Langford BJ, Brown KA, et al. The Association Between High and Unnecessary Antibiotic Prescribing: A Cohort Study Using Family Physician Electronic Medical Records. Clinical Infectious Diseases. 2021; 72(9):e345–e351. DOI: 10.1093/cid/ciaa1139
- Smieszek T, Pouwels KB, Dolk FCK, et al. Potential for reducing inappropriate antibiotic prescribing in English primary care. Journal of Antimicrobial Chemotherapy 2018; 73(suppl_2):ii36-ii43. DOI: 10.1093/jac/dkx500
- Van Staa T, Li Y, Gold N, et al. Comparing antibiotic prescribing between clinicians in UK primary care: an analysis in a cohort study of eight different measures of antibiotic prescribing. BMJ Quality & Safety 2022; 31(11):831-8. DOI: 10.1136/bmjqs-2020-012108
- Gulliford MC, Sun X, Charlton J, et al. Serious bacterial infections and antibiotic prescribing in primary care: cohort study using electronic health records in the UK. BMJ Open 2020; 10(2):e036975. DOI: 10.1136/bmjopen-2020-036975
- Pouwels KB, Hopkins S, Llewelyn MJ, et al. Duration of antibiotic treatment for common infections in English primary care: cross sectional analysis and comparison with guidelines. BMJ 2019; 364:l440. DOI: 10.1136/bmj.l440
- Bassetti S, Tschudin-Sutter S, Egli A, Osthoff M. Optimizing antibiotic therapies to reduce the risk of bacterial resistance. European Journal of Internal Medicine 2022; 99:7–12. DOI: 10.1016/j.ejim.2022.01.029
- Kenealy T, Arroll B. Antibiotics for the common cold and acute purulent rhinitis. Cochrane Database of Systematic Reviews , Issue 6. Art. No.: CD000247. DOI: 10.1002/14651858.CD000247.pub3
- Chua KP, Fischer MA, Linder JA. Appropriateness of outpatient antibiotic prescribing among privately insured US patients: ICD-10-CM based cross sectional study. BMJ 2019; 364:k5092. DOI: 10.1136/bmj.k5092
- Ferme S, Piednoir E, Delestre M, et al. Evaluation of antibiotic treatment initiation and duration practices in primary care. Cross-sectional study in two French multi-professional health centers. PLoS ONE 2024; 19(12):e0315128. DOI: 10.1371/journal.pone.0315128
- Saatchi A, Reid JN, Povitz M, et al. Appropriateness of Outpatient Antibiotic Use in Seniors across Two Canadian Provinces. Antibiotics 2021; 10(12):1484. DOI: 10.3390/antibiotics10121484
- Leslie M, Fadaak R, Lethebe BC, Szostakiwskyj JH. Assessing the appropriateness of community-based antibiotic prescribing in Alberta, Canada, 2017–2020, using ICD-9-CM codes: a cross-sectional study. CMAJ open 2023; 11(4):E579-E586. DOI: 10.9778/cmajo.20220114
- Lemiengre MB, van Driel ML, Merenstein D, et al. Antibiotics for acute rhinosinusitis in adults. Cochrane Database of Systematic Reviews 2018, Issue 9. Art. No.: CD006089. DOI: 10.1002/14651858.CD006089.pub5
- Smith SM, Fahey T, Smucny J, Becker LA. Antibiotics for acute bronchitis. Cochrane Database of Systematic Reviews 2017, Issue 6. Art. No.: CD000245. DOI: 10.1002/14651858.CD000245.pub4
- Smith SM, Smucny J, Fahey T. Antibiotics for acute bronchitis. JAMA 2014; 312(24):2678–9. DOI: 10.1001/jama.2014.12839
- Merenstein DJ, Barrett B, Ebell MH. Antibiotics Not Associated with Shorter Duration or Reduced Severity of Acute Lower Respiratory Tract Infection. Journal of General Internal Medicine 2024; 39(10):1887-94. DOI: 10.1007/s11606-024-08758-y
- Gonzales R, Bartlett JG, Besser RE, et al. Principles of Appropriate Antibiotic Use for Treatment of Acute Respiratory Tract Infections in Adults: Background, Specific Aims, and Methods. Annals of Internal Medicine 2001; 134(6):479-86. DOI: 10.7326/0003-4819-134-6-200103200-00013
- Ressel G. Principles of appropriate antibiotic use: part V. Acute bronchitis. American Family Physician 2001; 64(6):1098-100. PMID: 11578027
- Harris AM, Hicks LA, Qaseem A. Appropriate Antibiotic Use for Acute Respiratory Tract Infection in Adults: Advice for High-Value Care From the American College of Physicians and the Centers for Disease Control and Prevention. Annals of Internal Medicine 2016; 164(6):425-34. DOI: 10.7326/M15-1840
- Bugs & Drugs. Antibiotics. bugsanddrugs.org 2025. https://bugsanddrugs.org/4DC30123-6D6E-443B-8194-82C282604943
- Metlay JP, Kapoor WN, Fine MJ. Does this patient have community-acquired pneumonia? Diagnosing pneumonia by history and physical examination. JAMA 1997; 278(17):1440-5. PMID: 9356004
- Ebell MH, Chupp H, Cai X, et al. Accuracy of Signs and Symptoms for the Diagnosis of Community-acquired Pneumonia: A Meta-analysis. Academic Emergency Medicine. 2020; 27(7):541-53. DOI: 10.1111/acem.13965
- Choosing Wisely Canada. Using Antibiotics Wisely in Primary Care. https://choosingwiselycanada.org/primary-care/antibiotics/#prescriber-tools
- Choosing Wisely Canada. Viral Prescription Pad for Adults. https://choosingwiselycanada.org/wp-content/uploads/dlm_uploads/2021/11/RxFiles-Prescription-for-a-Virus_ADULT.pdf
- Choosing Wisely Canada. Pediatric Viral Prescription Pad. https://choosingwiselycanada.org/wp-content/uploads/dlm_uploads/2025/03/Pediatric_Viral_Prescription-1.pdf
- Lee C, Jafari M, Brownbridge R, et al. The viral prescription pad – a mixed methods study to determine the need for and utility of an educational tool for antimicrobial stewardship in primary health care. BMC Family Practice 2020; 21(1):42. DOI: 10.1186/s12875-020-01114-z
- Schwartz KL, Shuldiner J, Langford BJ, et al. Mailed feedback to primary care physicians on antibiotic prescribing for patients aged 65 years and older: pragmatic, factorial randomised controlled trial. BMJ 2024; 385:e079329. DOI: 10.1136/bmj-2024-079329
- Carney G, Maclure M, Patrick DM, et al. Pragmatic randomised trial assessing the impact of peer comparison and therapeutic recommendations, including repetition, on antibiotic prescribing patterns of family physicians across British Columbia for uncomplicated lower urinary tract infections. BMJ Quality & Safety 2025; 34(5):295–304. DOI: 10.1136/bmjqs-2024-017296
- Cheah R, Chen C, Capurro D, et al. A systematic review on how primary care electronic medical record data have been used for antimicrobial stewardship. Antimicrobial Stewardship & Healthcare Epidemiology (ASHE). 2025; 5(1):e16. DOI: 10.1017/ash.2024.499
- Di Mario S, Gagliotti C, Buttazzi R, et al. Reducing antibiotic prescriptions in children is not associated with higher rate of complications. European Journal of Pediatrics 2021;180(4):1185-92. DOI: 10.1007/s00431-020-03861-8
- Spurling GKP, Dooley L, Clark J, Askew DA. Immediate versus delayed versus no antibiotics for respiratory infections. Cochrane Database of Systematic Reviews 2023, Issue 10. Art. No.: CD004417. DOI: 10.1002/14651858.CD004417.pub6
- Meeker D, Knight TK, Friedberg MW, et al. Nudging guideline-concordant antibiotic prescribing: a randomized clinical trial. JAMA Internal Medicine 2014; 174(3):425-31. DOI: 10.1001/jamainternmed.2013.14191
- Yadav K, Meeker D, Mistry RD, et al. A Multifaceted Intervention Improves Prescribing for Acute Respiratory Infection for Adults and Children in Emergency Department and Urgent Care Settings. Academic Emergency Medicine 2019; 26(7):719-31. DOI: 10.1111/acem.13690
- Miller BJ, Carson KA, Keller S. Educating Patients on Unnecessary Antibiotics: Personalizing Potential Harm Aids Patient Understanding. Journal of the American Board of Family Medicine: JABFM 2020; 33(6):969-77. DOI: 10.3122/jabfm.2020.06.200210
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