Antibiotic stewardship garners a lot of attention these days, but we face unique challenges to execute guidelines successfully given that we write more than 13 million antibiotic prescriptions every year in EDs.

Variations in outpatient antibiotic treatment duration exist for many reasons. Historically, most of the data on duration were not reported by randomized, controlled trials, leaving many physicians to fill in the gaps when they read estimated durations.

Barriers to a lack of guaranteed follow-up, with many patients not having a primary care physician, force emergency physicians to be heavy-handed rather than judicious.

Thankfully, there have been increasing numbers of well-designed studies that demonstrate non-inferiority from shorter duration of antibiotics compared with standard treatment regimens.

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