What is a key principle of antimicrobial stewardship (AMS)?

• A. Use delayed prescriptions for all infections
• B. Always use broad-spectrum antibiotics first
• C. Use delayed prescriptions when appropriate
• D. Shorten antibiotic courses to 3 days always

Answer: (C)

Antimicrobial stewardship aims to ensure antibiotics are used only when needed and in the right way. A key principle is using delayed prescriptions when appropriate. This means giving a prescription but asking the patient to wait 24–48 hours to see if symptoms improve before filling it. It helps distinguish infections that improve on their own from those that truly need antibiotics, reducing unnecessary exposure, side effects, and the risk of resistance while still keeping a safety net if the patient worsens.

This approach isn’t suitable for all infections—some conditions require immediate treatment or urgent assessment. In stewardship, when antibiotics are needed, they should be chosen thoughtfully (favoring narrower-spectrum options when possible and tailoring based on response), rather than automatically starting with broad-spectrum agents. Likewise, durations aren’t fixed to a universal number like three days; they should be based on evidence for the specific infection and the patient’s progress.