“Ten commandments” for the appropriate use of antibiotics by the practicing physician in an outpatient setting

A multi-national working group on antibiotic stewardship, from the International Society of Chemotherapy, put together ten recommendations to physicians prescribing antibiotics to outpatients. These recommendations are:

(1)  use antibiotics only when needed; teach the patient how to manage symptoms of non-bacterial infections;

(2)  (2) select the adequate ATB; precise targeting is better than shotgun therapy;

(3)  (3) consider pharmacokinetics and pharmacodynamics when selecting an ATB; use the shortest ATB course that has proven clinical efficacy;

(4)  (4) encourage patients compliance;

(5)  (5) use antibiotic combinations only in specific situations;

(6)  (6) avoid low quality and sub-standard drugs; prevent prescription changes at the drugstore;

(7)  (7) discourage self-prescription;

(8)  (8) follow only evidence-based guidelines; beware those sponsored by drug companies;

(9)  (9) rely (rationally) upon the clinical microbiology lab; and

(10)     (10) prescribe ATB empirically – but intelligently; know local susceptibility trends, and also surveillance limitations.