Shared decision making and antibiotic stewardship: Will pharmacists rise to the challenge?

Jeff Singh, a 46-year-old otherwise healthy male, enters the pharmacy with a prescription for moxifloxacin 400 mg PO daily for 7 days. He comes in after 10 days of persistent cough that has bothered him so much that he was having trouble falling and staying asleep. Mr. Singh had a fever during the first few days of the illness but now he is just really bothered by the cough, which is producing greenish-yellow sputum. He visited a walk-in clinic a few days before and the doctor indicated he “likely has bronchitis, which is usually caused by a virus,” but said “just in case,” he would give Mr. Singh a prescription for antibiotics. He left it up to Mr. Singh to decide if he was feeling ill enough to take the medication. Worried that his cough is persisting, he asks for the pharmacist’s advice.