Table 1 Recommendations for interventions to change clinician prescribing behavior

1. Give explicit antibiotic prescription recommendations

2. Give alternative treatment options (including for parents e.g. home care advice, and clinicians e.g. delayed scripts)

3. Address the treatment/no treatment distinction made by clinicians

4. Give information on specific symptoms

5. Should address both clinicians AND parents (though we don’t know if there is a difference if they receive information together)

6. Should provide information on prognosis that is tailored to the child and addresses the common and/or stated (not implied) concerns of parents

7. Address known environmental pressures (e.g. external pressures to prescribe/consult)

8. Should make clinicians feel more confident/experienced

9. Acknowledge treatment decisions in care of childhood RTIs are usually made in the absence of definitive diagnosis. Novel methods to reduce uncertainty may be helpful.

10. Be designed in consultation with clinicians and parents

1. Work against the environment in which clinician operates (e.g. in conflict with targets)

2. Be generic

3. Patronize or undermine parental or clinician decision making

4. Be passive (e.g. posters)

5. Increase anxiety or perception of risk for either party