'Ten commandments' for the appropriate use of antibiotics by the practicing physician in an outpatient setting

Gabriel Levy-Hara, Carlos F. Amábile-Cuevas, Ian Gould, Jim Hutchinson, Lilian Abbo, Lynora Saxynger, Erika Vlieghe, Fernando L. Lopes Cardoso, Shaheen Methar, Souha Kanj, Norio Ohmagari, Stephan Harbarth, Alex Aiken, Amani Alnimr, Luis Bavestrello, Jean Carlet, Anahi Dreser, Sabiha Essack, Po Ren Hsueh, Nadia IsmailDeogratias Kaddu-Mulindwa, Hans Jørn Kolmos, Takahiro Mochizuki, Linus Ndewga, Carla Odio, Miguel Angel Peredo, Silvio Vega, Rajlakshmi Viswanathan, Heiman Wertheim

Research output: Contribution to journalArticlepeer-review

26 Scopus citations


A multi-national working group on antibiotic stewardship, from the International Society of Chemotherapy, put together ten recommendations to physicians prescribing antibiotics to outpatients. These recommendations are: (1) use antibiotics only when needed; teach the patient how to manage symptoms of non-bacterial infections; (2) select the adequate ATB; precise targeting is better than shotgun therapy; (3) consider pharmacokinetics and phar-macodynamics when selecting an ATB; use the shortest ATB course that has proven clinical efficacy; (4) encourage patients' compliance; (5) use antibiotic combinations only in specific situations; (6) avoid low quality and sub-standard drugs; prevent prescription changes at the drugstore; (7) discourage self-prescription; (8) follow only evidence-based guidelines; beware those sponsored by drug companies; (9) rely (rationally) upon the clinical microbiology lab; and (10) prescribe ATB empirically - but intelligently; know local susceptibility trends, and also surveillance limitations.

Original languageEnglish (US)
JournalFrontiers in Microbiology
Issue numberNOV
StatePublished - 2011


  • Antibiotic resistance
  • Antibiotic stewardship
  • Generic antibiotics
  • Guidelines
  • Self-prescription
  • Treatment compliance

ASJC Scopus subject areas

  • Microbiology
  • Microbiology (medical)


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