6 steps to take when a patient insists on that antibiotic

4. Set realistic expectations. Tell patients how long their cough is likely to last. The duration of the typical cough is (unfortunately) about 17 days.³ Most patients (and even some doctors) think a bad cold should be gone in 7 days.³

5. Choose your terms carefully. Don’t use the term “acute bronchitis.” It sounds bad and worthy of an antibiotic. “Chest cold” sounds much more benign; patients are less likely to think they need an antibiotic for a chest cold.⁴

6. When all else fails, consider a delayed prescription. I reserve this strategy for patients who are insistent on getting an antibiotic even though their illness is clearly viral. Randomized trials of the delayed strategy show that fewer than 50% of patients actually fill the prescription.⁵

Develop your own spiel to reduce unnecessary antibiotic prescribing. You’ll find that it works a good deal of the time.