Stephen I. Feller , 2025-04-29 15:57:00
April 29, 2025
2 min read
Key takeaways:
- Reviewing physical exams and making clear diagnoses can help avoid unneeded antibiotics prescriptions.
- Tools for how to speak with and educate patients on antibiotic stewardship are available online.
ORLANDO — Patient education and more effective communication can help doctors from feeling forced to prescribe antibiotics for patients who do not need them, SHEA Spring attendees heard at a session during the conference’s first day.
Ritu Banerjee, MD, PhD, professor of pediatric infectious diseases at Vanderbilt University Medical Center, delivered guidance and data she said can help clinicians avoid unnecessary antibiotic prescriptions when their patients clearly expect to receive one.
The presentation included a host of online tools for clinicians themselves, as well as videos and written materials, to help patients understand when they, or their children, do not need antibiotics — conversations that can cause strife between clinicians and their patients.
Banerjee told Healio after the session that she considers patient interaction to be an important topic because “in medical school, I received no [specific] training in communications skills” for how to interact with patients with expectations for medications and how to handle it.
“It was more of a see one, teach one kind of thing — you see how your attending physicians are speaking with patients and model your behavior on it,” she said.
Among the reasons Banerjee said clinicians cite as reasons for inappropriate prescriptions are a patient and parent demand for antibiotics. According to her presentation, difficulty explaining why an antibiotic is not needed, not wanting the patient to leave “empty-handed,” not wanting to harm the doctor-patient relationship and avoiding poor patient satisfaction scores dominate these explanations.
During the session, Banerjee quoted one of her father’s favorite proverbs, comparing the doctor-patient relationship with clapping because these relationships require both sides for success, which means that clinicians need to be aware of patient expectations, as well as their perspectives.
“It takes two hands to clap — there’s two sides to every story,” Banerjee said. “This is a complex interaction, between a clinician and a patient. What about the patient’s side? We’re focused on what clinicians are trying to do. … Remember, there are things that we can do to set expectations.”
In paying attention to context clues from patients, clinicians already notice when they hear that a friend or family member has had an infection and received a prescription, she said. Working with patients to help them understand that antibiotics may be completely uncalled for can be delicate depending on the patient, Banerjee said, recommending a Dialogue Around Respiratory Illness Treatment (DART) review.
The review, which starts with going over physical exam findings and giving a clear diagnosis, recommends giving patients “the bad news first” and then making positive treatment recommendations — and having a contingency plan — which can make the conversation significantly easier.
“We should realize that patients understand that we need to be using antibiotics judiciously,” Banerjee said. “In situations where there might be disagreement between a clinician’s decision to prescribe an antibiotic and a patient’s expectation for antibiotics, there are strategies you can use to have a fruitful conversation about it so that the encounter ends on a positive note for everybody.
“I think clinicians are very appreciative of having these short, simple training modules and strategies that can help them be more proactive in how they’re approaching every encounter,” Banerjee said.
For more information:
Ritu Banerjee, MD, PhD, can be reached at ritu.banerjee@vumc.org.
Sources/Disclosures
Collapse
Banerjee R. Teach them to fish: Training clinicians to talk to patients about antibiotics. Presented at: SHEA Spring 2025; April 27-30, 2025; Orlando.
Disclosures:
Banerjee reports receiving research support from the CDC and NIH.
