According to an editorial, reducing inappropriate prescribing requires behaviour change by clinicians. A peer-referenced individualised prescribing feedback system would work optimally if it met the following three criteria.
1. A diagnostic code is recorded every time an antibiotic is prescribed.
2. All infections should be coded, not just those for which an antibiotic is being prescribed.
3. Use of a global measure of illness severity (such as mild, moderate, or severe) with each diagnostic code.
It acknowledges that individualised feedback is only one of a raft of antimicrobial stewardship strategies needed to improve prescribing, none of which will work in isolation. Others include better infection control, vaccination, and improved diagnostic precision, but the incentive for improving diagnostic coding is to provide information that can be used by clinicians to help them reflect and refine their prescribing behaviour.