The phrase that worked best was "This prescription is a safety net, not the plan", followed by clear criteria for when to use it. In practice, saying "If these symptoms haven't improved after 48 hours or you develop X, then fill it" reframed antibiotics as conditional, not expected. In one case, a patient who initially pushed for antibiotics chose to wait, symptoms resolved, and the prescription was never used because the wording gave permission to delay without feeling dismissed Albert Richer, Founder, WhatAreTheBest.com
One specific phrase I use to support delayed antibiotic prescribing is watching and waiting. (that is great!) In addition to discussing protecting the human microbiome, I explain that many illnesses can be caused by a viral illness, and antibiotics in these scenarios will cause more harm than benefit. I emphasize supportive care such as diet, sleep, and fluids, in addition to honey for children above age 1 to help treat sore throats, or pharyngitis. Strep throat is NOT a scenario where I would avoid antibiotics. Based on clinical criteria, a child may qualify for antibiotics without a strep test at all. For a sore throat (NOT caused by the strep bacteria or other bacteria), sending a throat culture while closely monitoring symptoms and providing supportive care with pain medications, honey, tea, and close observation is the more conservative approach. Since many are due to other viruses, antibiotics are not helpful and may even be harmful. For example, trialing Tylenol, ibuprofen, and salt gargles in the emergency department may help the patient feel better and feel cared for and supported. Knowing that a throat culture was sent is helpful to identify bacteria and the need for other intervention.