Better, not just fewer: Rethinking antibiotic prescribing

This perspective argues that tackling antimicrobial resistance requires not just reducing antibiotic use, but improving the quality of prescribing decisions. It highlights evidence from a large study in Rwanda showing that a digital clinical decision support tool (ePOCT+) can dramatically reduce unnecessary antibiotic prescriptions (from ~70% to ~25%) without harming patient outcomes. However, the authors stress that technology alone is insufficient—effective antibiotic stewardship also depends on clinician behavior, training, health system factors, and governance. Overall, the paper calls for a shift toward “better, not just fewer” prescriptions, combining digital tools with broader systemic and behavioral interventions to ensure safe, equitable, and sustainable use of antibiotics.