Why fewer antibiotics is better care

Most everyday infections aren't bacterial

The large majority of the illnesses that bring people into a general practice clinic — sore throats, coughs, colds, most fevers, many ear infections — are caused by viruses, not bacteria. Antibiotics treat bacterial infections. They do nothing at all against a virus. Taking one for a viral illness won't make it resolve faster, won't reduce how unwell you feel, and carries a real downside for no corresponding benefit.

The confusion is understandable: many viral and bacterial infections look and feel similar in the first day or two, and antibiotics have such a strong reputation as "the thing that fixes infections" that it's easy to assume they help with anything that feels like one. Telling the two apart is exactly the judgement a consultation is for — it isn't guesswork, and it isn't something a symptom checklist alone can safely do.

The real cost of prescribing "just in case"

Antibiotics aren't harmless when they aren't needed. Every course carries side effects of its own — commonly digestive upset, and occasionally more serious reactions. Beyond the individual patient, unnecessary antibiotic use contributes to antibiotic resistance: bacteria that survive repeated, often unnecessary exposure to a drug become progressively harder to treat with it. This is a genuine and growing concern, not a theoretical one, and it means an antibiotic prescribed today for a viral illness can make a real bacterial infection harder to treat, for that same patient, years down the line.

Prescribing conservatively is not the same as prescribing reluctantly or under-treating a genuine infection. When a bacterial infection is actually present and needs an antibiotic, the right response is to prescribe one, promptly and at the correct course length. The point of a conservative approach is precision — treating what needs treating, and not treating what doesn't — not avoidance for its own sake.

What this looks like in a consultation

A careful approach to prescribing means the consultation itself does more work: a proper history, a look at how long symptoms have lasted and how they've progressed, and — where it changes the decision — a physical examination, rather than reaching for a prescription pad on the basis of a symptom described over the counter. It can mean being told that a course of rest, fluids and time is the right treatment for a viral illness, even when you came in hoping for a prescription. That's not a doctor declining to help — it is the same clinical judgement that, in a different case, leads to prescribing exactly the right antibiotic without hesitation.

This same reasoning — treat what genuinely needs treating, hold back what doesn't, and make that judgement from the patient's actual history and presentation rather than a request — runs through every part of the clinic's approach, including the childhood immunisation schedule: a vaccine given at the wrong time can under-protect a child just as easily as an unnecessary antibiotic can cause harm without benefit. Neither decision is made to be difficult. Both are made to actually be right.

If you're not sure why you weren't prescribed something

If you've left a consultation without an antibiotic you expected, it's always reasonable to ask directly what the reasoning was — a good explanation costs nothing and should make sense to you. That conversation is part of the care, not an afterthought to it.