How can I identify patients at higher risk for antibiotic resistance in my practice?

To identify patients at higher risk for antibiotic resistance in your general practice, consider both individual patient risk factors and local antimicrobial resistance patterns. Key patient-related risk factors include a history of recent or frequent antimicrobial use, recurrent or persistent infections, and previous infections with resistant organisms. Taking microbiological samples before prescribing antibiotics in such cases can help guide targeted therapy and identify resistance early ¹.

Additionally, patients with comorbidities, immunosuppression, or those recently discharged from hospital are more likely to harbour resistant pathogens and should be assessed carefully before prescribing antimicrobials ¹. Using local prescribing and resistance data to inform risk stratification is essential; antimicrobial stewardship teams can support this by reviewing prescribing patterns and resistance trends within your practice or locality ¹.

Implementing decision support tools and IT systems can assist prescribers in evaluating whether antimicrobials are necessary and in selecting appropriate agents, especially for patients with risk factors for resistance ¹. Safety-netting advice and patient education about appropriate antimicrobial use also help reduce inappropriate demand and use, which contribute to resistance development ².

Recent systematic reviews highlight that risk factors for drug-resistant pathogens in community-acquired infections include prior antibiotic exposure, recent hospitalization, and certain comorbidities, reinforcing the importance of thorough clinical assessment and history-taking to identify at-risk patients (Nakagawa et al., 2025). Integrating these clinical risk factors with local resistance data and stewardship support optimizes identification and management of patients at higher risk for antibiotic resistance.