Inappropriate and Unnecessary Prescription of Antibiotic


Author’s name

forrespiratory infections

Research has indicated that more than half of respiratory infectionsare as a result of viruses. The various respiratory infections thatclinicians prescribe antibiotics for include but not limited to sorethroat, sinusitis, ear infection, bronchitis and upper respiratoryinfection. Some of these respiratory infections do not need theprescription of antibiotics and therefore medical experts argue thattheir prescription is more than what is needed. In the United Statesalone, over 11 million antibiotic prescription to children and minorsare unnecessary and sometimes harmful (Beracocheaet al., 2011). Antibiotics are only useful in cases where theinfections are caused by bacteria. Unfortunately, a majority of therespiratory infections are viral and therefore antibiotics areprescribed unnecessarily and inappropriately.

The American Academy of Pediatrics published a study conducted byDr. Matthew Kronman, which highlighted how antibiotics areinappropriately and unnecessarily prescribed to young children andteens. The research found out that there are 57% antibioticprescriptions for all respiratory infections reported (Beracocheaet al., 2011). However, the research also found out that outof the 57% prescriptions, there are only 27% infections that arecaused by bacteria. In this regard, it is evident that there are morethan half antibiotics prescriptions that are unnecessary.

Clinical excellence

Nurses have the responsibility of ensuring that they deliver thebest quality care to their patients. Clinical excellence, accordingto the National Health Service, is ensuring that clinical officersand nurses offer the best possible quality care to patients. Healthprofessionals must be in the frontline in educating the members ofthe public on the dangers of unnecessary prescription of antibiotics.More often than not, health care providers do not have equipment thatcan determine whether a respiratory infection is a viral or abacterial disease. Therefore, it is inevitable that the nurses end upprescribing antibiotics even in cases where they are not needed.

Inappropriate and unnecessary prescription of antibiotics forrespiratory infections has long term side effects and is also costly.The development of antibiotic resistant infections has largely beenblamed on these unnecessary prescriptions. There are instances wherehealth professionals argue that they do not have sufficient time todo all what is required to offer quality care to a patient. As aresult, cases of inappropriate prescriptions occur and the sideeffects are dire. According to the National Healthcare SafetyNetwork, healthcare providers, administrators, patients and thegovernment policy makers have a role to play in ensuring clinicalexcellence (Beracochea et al., 2011).

The healthcare providers must provide the necessary and correct carethrough carrying out the relevant tests. They must ensure thatpatients are given the right drugs and the right dosage. Thehealthcare providers must also reassess the antibiotic prescriptionsafter 48 hours on the basis of the tests they carried out and thepatient examination. In order to attain clinical excellence, it isprudent for the healthcare providers to keep record of theantibiotic’s dosage and duration in their healthcare facility. Allthe nurse practitioners must work on the realm of respect forpatients, generosity and doing justice (Slawsonet al., 2012). These are ethicalstandards that are essential in providing holistic patient-centeredhealthcare. Justice in the healthcare profession is an obligationupon the healthcare providers to offer quality care according to thelaw. Respect for patients encompasses doing what is good to thepatients and avoiding harming the patient. Generosity on the handrequires the healthcare provider to offer quality and patientcentered care according to the established morals. All the abovethree ethical principles must be put in place in order to providequality patient centered healthcare services. Clinical excellence isalso achieved through collaboration, consultation and continuouseducation. It is also imperative for the healthcare providers to haveself-reflection sessions.

The healthcare center administrators have the responsibility ofdeveloping a working feedback system from the patients. This shouldbe aimed at ensuring that the nurses and or the health professionalsare able to attain excellence over time. Unnecessary andinappropriate prescription of antibiotics or over prescription hasnumerous side effects. Beside the development of antibiotic resistantbacterial infections, the ailing patient may suffer and can alsoinfect other people (Slawsonet al., 2012). It is evident thatwith proper prescription of antibiotics for respiratory infections,the side effects of unnecessary and inappropriate prescriptions willbe avoided.

A model for change

Various national health institutions provide informationregularly on how to improve healthcare provision to the people. Forthe case of unnecessary and inappropriate prescription of antibioticsfor respiratory infections, there are various models for change thatcan be adopted to alleviate the problem. Research has indicated thatthe problem is fueled by the lack of awareness and health informationto both the clinical nurses and the patients (Chamberset al., 2013). Majority of patients with viral respiratoryinfections insist on being given a dosage of antibiotics. In theentire of Europe, antibiotic awareness campaigns are carried outevery year. This is aimed at educating the public and the entirehealthcare industry on the dangers of wrongful prescription ofantibiotics.

The awareness campaign, which is supported by Department of Healthand its Advisory Committee on Antimicrobial Resistance and HealthcareAssociated Infections has achieved tremendous success in reducingcases of inappropriate antibiotics prescription. The CDC`s NationalHealthcare Safety Network has come up with various strategies thatcan be used to deal with this problem.

Antibiotic stewardship programs

These are programs that can be adopted in the healthcarefacilities to deal with the issue of wrongful prescription ofantibiotics for respiratory infections. In order to achieve theoutcomes of the program, it is prudent to appoint a leader foraccountability purposes. Research has indicated that physicians canoffer the best leadership for antibiotic stewardship programs. It isimperative to ensure that the program has enough resources, humanresource personnel and the necessary information technology equipment(Chambers et al., 2013). Prescriptionimprovement actions such reassessment after 48 hours must beincorporated into the program to ensure its success.

Tracking of the various trends of prescribing and antibioticresistance cases is essential in order to take the necessary action.The patters obtained from the tracking must be communicated to thestaff in order to come up with ways of improving. The program alsoencompasses education to the staff on improving the prescriptionpractices, as well as about antibiotic resistance (Slawsonet al., 2012). It is also vitalto work with other healthcare facilities to avoid further infectionsand or transmissions.

Theoretical Model and Framework

Community health promotion model

Promoting healthy practices amongst thecommunity is one of the best models to address the problem ofunnecessary prescription of antibiotics for respiratory infections.There are numerous cases where the patients are the ones who insistthat the nurse should prescribe a particular antibiotic for theirillness (Slawson et al., 2012).However, the patient might be unaware that the ailment does not needan antibiotic. Additionally, it is evident that a majority ofpatients purchase antibiotics, or store antibiotics that prescribedto them for future use. Equally, there are patients who useantibiotics that were prescribed for other people whom they assumehave similar illness as theirs.

It is, therefore, extremely necessary toeducate the populace on the proper ways of using antibiotics. Thiswill help in reducing the numerous cases of antibiotic resistantbacteria. It is vital to educate the public on taking the preventivemeasures by following the prescription and dosage directives from thehealth professionals.

Step 1: Assess the Need for Change in Practice


The main aim of this model is to offerpreventive measures as opposed to curative measures. The public mustbe educated on the dangers of unnecessary prescription on a timelymanner to avoid the discussed side effects. However, there is alwaysthe problem of reaching the entire population. There are people whoare unreachable and therefore the problem of antibiotic resistantbacterial continues. The cost of educating the public aboutantibiotic resistance and over prescription, as well as inappropriateprescription is a major hindrance.


The use of health practitioners at healthfacilities will enable transmission of knowledge to the patientssuffering from respiratory infections or antibiotic resistantbacterial infections. It is critical for the nurses at the healthfacilities to offer education to the patients with regard toantibiotic prescriptions (Beracochea etal., 2011). Provision of the rightantibiotics is also essential to ensure that the patients are offeredquality patient centered healthcare. The health practitioners mustalso offer advice to the patient on the various healthy lifestylesand the measures to take to avoid over prescription, unnecessaryprescription or antibiotic resistance.


Thehealthcare providers must set goals for patients practicing overprescription of antibiotics or patients who are taking antibioticsunnecessarily. The providers can set out activities that involveproper prescription of antibiotics to a patient by a healthpractitioner.


Beracochea, E., Weinstein, C., &amp Evans, D.P. (2011).&nbspRights-basedapproaches to public health. NewYork: Springer Pub. Co.

Chambers, R., Wakley, G., &amp Blenkinsopp, A.(2013).&nbspSupportingself-carein primary care. Abingdon:Radcliffe.

Slawson, D., Shaughnessy, A., &amp Ebell, M.(2012).&nbspEssentialEvidence: Medicine That Matters. Hoboken:John Wiley &amp Sons.