Patients are likely to better understand and accept a back-up/delayed antibiotic prescription if you discuss two key points:
- Reasons for giving it
It can be helpful to:
- provide reassurance that there is no need for an immediate antibiotic prescription and, if given, the patient is more likely to experience the side effects of antibiotics rather than the benefits;
- although the illness is likely to be self-limiting, acknowledge that it is not possible to predict exactly how the illness will progress;
- and that you would like the patient to have access to antibiotics should their symptoms get worse or not improve as expected.
- Specific number of days to wait
For example: "wait another 2 days and start the antibiotic if you are not feeling any better by then".
- It is important to be specific as your patient may worry about waiting too long if they are not confident about when to start the antibiotics.
- Your advice should be tailored to the patient’s current experience of the infection, the prior duration and expected natural history, their co-morbidities, and their ability to access antibiotics in a timely manner. The TARGET patient information leaflets can help with this.
These can be incorporated in the last four techniques in CHESTSSS (Timeline, Shortcomings, Self-care, Safety-netting).