Although many countries have been successful in reducing primary care prescribing of antimicrobials, primary care is still responsible for the majority of antibiotics prescribed to people.3 4 Much of this use is in the treatment of suspected respiratory infection and levels of prescribing vary widely within5 and between countries,6 suggesting that further reductions are possible. However, there are many barriers to reducing the inappropriate use of antimicrobials, including: patient and practitioner expectations,7 lack of patient awareness of the problems caused by antimicrobial resistance,8 and a perception in primary care clinicians and patients that antibiotic resistance is only a theoretical9 or minimal10 risk. Although the reason for such views being held is unclear, it may in part be because some previous studies have only investigated the relation between prescribing and resistance with population level data.11 12 13 Consequently for clinicians, whose primary concern is the unwell individual pandora earrings, the impact of antimicrobial use on the prevalence of societal resistance may not be an important consideration.14 To reduce prescribing, it may therefore be important to highlight the effect of antimicrobial use on emergent resistance for individuals.15.
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