Antimicrobial Stewardship: Not Just a Prescriber Issue

Antimicrobial stewardship can sound like a highly clinical topic; something that sits only with GPs, pharmacists or infectious disease specialists.

But in primary care, good antimicrobial stewardship is a whole-team effort.

At its core, antimicrobial stewardship is about supporting the safe and appropriate use of antimicrobials, including antibiotics, antivirals, antifungals and antiparasitic medicines. It aims to reduce unnecessary use, preserve the effectiveness of these medicines, and protect patients from avoidable harm.

With antimicrobial stewardship receiving greater attention in the RACGP 6th Edition direction, now is a good time for practices to think about how this work already happens, and where simple improvements can be made.

For prescribers, antimicrobial stewardship includes using current clinical guidelines, choosing the right medicine when one is needed, limiting duration where appropriate, considering narrow-spectrum options, and reviewing treatment when symptoms change or results become available.

But the rest of the practice team also plays an important role.

Nurses may help reinforce key messages with patients, identify deterioration, support follow-up, or notice patterns in recurrent presentations. Reception and administration staff may help patients understand when appointments are needed, support recall and reminder systems, and ensure messages are escalated appropriately. Practice managers can support access to current guidelines, monitor training, coordinate audits, and include antimicrobial stewardship in team meeting discussions.

Even small communication moments matter. For example, helping patients understand that antibiotics do not treat viral infections can reduce pressure on clinicians and support better shared decision-making. Clear instructions about how to take medicines, what side effects to watch for, and when to seek further review can also improve safety and adherence.

Practices do not need to build a complicated antimicrobial stewardship program overnight. A practical starting point might include:

• ensuring clinical guidelines are easy to access
• discussing antimicrobial stewardship at a clinical or team meeting
• reviewing a small sample of prescribing patterns
• checking how patients are given information about antibiotics
• using patient resources to support conversations
• identifying how non-clinical staff should respond when patients request antibiotics
• documenting follow-up processes where infection risk is higher

The aim is not to make prescribing harder. It is to make good prescribing easier, and to ensure the whole system supports safe, evidence-informed care.

Like many quality improvement activities, antimicrobial stewardship works best when it is practical, proportionate and embedded into existing systems.

QIP Consulting supports general practices to prepare for changing accreditation expectations in ways that are realistic and workable. Ready to review your antimicrobial prescribing? Reach out to us.