Moving Us Closer To Osler
A Miller Coulson Academy of Clinical Excellence Initiative

How to Talk to Patients About Unnecessary Antibiotics


When talking with patients about antibiotics that are not indicated, emphasize personal potential side effects such as yeast infections and diarrhea.

How do you most effectively talk with patients for whom antibiotics aren’t indicated? Our study showed that personalizing the potential harm can help aid patient understanding, as opposed to discussing the public health ramifications of antibiotic resistance.


When speaking with patients requesting unindicated antibiotics, we tested specific statements to see which most dissuaded them. They were statements either about personal harm, harm to people close to the patient, or harm to society. Our results suggest that concise statements focused on the personal harm of antibiotics are more effective than statements about harm to society. We also found that not mentioning antibiotic resistance was more effective than talking about it.


These results are notable because many clinicians and public health campaigns often focus on large-scale thinking. Instead, it’s more effective to talk about personal side effects and avoiding mentioning antibiotic resistance.


Here are our top 2 tips when talking with patients requesting unindicated antibiotics:


1. Avoid discussing “antibiotic resistance” or national/global public health impacts.

These topics are less likely to dissuade patients. Focus on personal side effects instead.


2. Make the harm of unindicated antibiotics personal.

Discuss potential side effects of yeast infections, weight gain, and/or diarrhea.



This piece expresses the views solely of the authors. It does not represent the views of any organization, including Johns Hopkins Medicine.