GPs should have rapid tests for viral and bacterial infections to know if they should give patients antibiotics, Newcastle virologist Nathan Bartlett says.
A shortage of antibiotics occurred this winter, with GPs prescribing more medication to treat a four-fold rise in pneumonia cases.
Professor Bartlett, of Hunter Medical Research Institute, said "we need to better work out what the bug is, so we don't unnecessarily prescribe antibiotics".
The prominent academic, who was named Newcastle Citizen of the Year in January, said rapid tests were needed to address the problems of antibiotics shortages and resistance.
"This flu season we've had a resurgence of respiratory bacterial pathogens - whooping cough (pertussis) and mycoplasma pneumoniae (walking pneumonia).
"Both can cause serious lung infections and pneumonia, particularly in young kids."
NSW Health data shows whooping cough cases rose to 316 in Hunter New England in July, the highest monthly rate since modern records began in 1991.
These recorded cases involve people sick enough to be tested.
"If a child presents to a GP and they clearly have a severe respiratory infection, they're going to prescribe antibiotics," Professor Bartlett said.
This was particularly the case when "they know there's a lot of bacterial infections around".
"So there's a good chance it could be a bacteria, but there's also a very good chance it's not. It could be RSV, influenza or rhinovirus.
"A lot of antibiotics are prescribed unnecessarily because GPs don't have an easy way of discriminating between a virus and bacteria, so they give antibiotics just to be safe.
"And they're totally doing the right thing, they have no choice."
Dr Milton Sales, who runs the Brunker Rd General Practice at Adamstown, said GPs were "in a bind" when considering whether to prescribe antibiotics.
GPs don't want patients to "end up with life-threatening pneumonia", having not prescribed the medicine.
"With pneumonia, some are viral and some bacterial. The bacterial ones can make people very sick very quickly and risk lives.
"Sometimes a chest X-ray can give a clue if an antibiotic is more needed than not."
Dr Sales said it would be great if GPs had cheap, government-funded diagnostic tests "to guide our antibiotic prescribing".
GPs could not cover the cost of such tests, as they were already dealing with government cost-shifting through inadequate Medicare rebates.
A spokesperson for the federal Department of Health said it had recently established a working group to develop a paper by early 2025 on "point of care pathology tests".
The federal government was "keen to work" on evolving technologies in health technology "in the context of limited health-care resources".
Dr Sales said there were rapid tests for influenza A and B, COVID and RSV.
"If those three are negative, it makes it a bit more likely it could be something like mycoplasma," he said.
"But there are many other viruses"
He added that there were rapid tests for streptococcus, the bacteria that causes sore throat and tonsillitis, "but they cost us about $20 per test".
He said the antibiotic shortage had been "a major drama".
There was a shortage of paediatric amoxicillin last year, while this year liquid macrolide antibiotics were in short supply.
Professor Bartlett said young children need the liquid form, as "they won't take pills".
"Mums have been going from pharmacy to pharmacy, trying to find someone who'll sell the liquid antibiotics because their kids are sick," he said.
