Inappropriate antibiotic use in primary care remains a major driver of antimicrobial resistance, partly due to the long-standing underemphasis on antibiotic harms in healthcare training. Because primary care accounts for most global antibiotic prescribing, reducing unnecessary use is essential for both patient safety and resistance prevention.
Drawing on evidence from multiple countries, this article shows that effective solutions must go beyond individual prescribers and address context-specific, organizational, and system-level factors, including communication, continuity of care, interprofessional collaboration, updated guidelines, and national stewardship programmes. Overall, a multifaceted, system-based approach is required to sustainably improve antibiotic use in primary care.
