Most unnecessary antibiotic days are not decided — they accumulate. The drug was started on a Friday by someone who is now off, the plan said review in 48 hours, the review happened and concluded the patient was improving, and nobody wrote down when it should end. By day six the question has become whether to stop, which is a harder question than whether to continue would have been on day three.
So write the intended stop date in the same action as the prescription, on the chart and in the notes, with the indication beside it. It costs nothing and it changes the default: a course with an end date has to be actively extended, while a course without one has to be actively stopped, and only one of those reliably happens on a busy ward.
The same discipline makes handover useful. A colleague covering the weekend can act on 'community-acquired pneumonia, stop 22nd' without reconstructing the original reasoning; they cannot act on 'co-amoxiclav'.
- Record indication and intended stop date with every antibiotic prescription
- Make extending a course the action that needs a note, not stopping it
- State the stop date at handover rather than the drug name alone
- Review intravenous-to-oral switch at the same point you review duration
Why it matters
Unnecessary antibiotic days are usually inherited rather than chosen, and an end date is what stops the inheritance.
Read the rest in the app
You have read your two free briefings this month. The app carries all 27 specialties, every morning, free — and this finding is waiting in it.
Scan to keep reading on your phone. No account needed to start.
Tomorrow morning, before your first patient
One edition a day for infectious diseases, written by the desk, every claim tied to its paper. Six minutes.
Get the app — free