Antimicrobial prescribing still growing despite curbing efforts


pills spill out of beaker

New findings launched today show that Australia has higher antimicrobial use than England, Canada, Norway, Denmark, Sweden and the Netherlands – and the number of antimicrobials prescribed in Australia continues to grow.

NPS MedicineWise is again urging Australians to stop expecting antibiotics for viruses such as colds and flu.

The first AURA (Antimicrobial Use and Resistance in Australia) Report includes NPS MedicineWise MedicineInsight data from 182 doctors’ practices. The data shows that, where an antibiotic was prescribed and a reason given for that prescription, up to 50% of patients who had a cold or upper respiratory tract infection had an antibiotic prescribed when it wasn’t actually needed.

NPS MedicineWise CEO Dr Lynn Weekes welcomed the AURA Report as the first report of its kind to give a nationally coordinated overview of antibiotic use and antibiotic resistance, but expressed concern as it proves many common misconceptions continue to persist around the use of antibiotics for viral infections like ordinary colds and flu.

“When we are facing a future where antibiotics may no longer work when we need them, this data is crucial in helping health professionals, policy makers and consumers alike to understand that they each play a part in making sure these life-saving medicines continue to work both now and in the future,” she says.

A new NPS MedicineWise survey of 1000 Australians, also released today, has revealed that four in ten people (38%) who went to the doctor last time they or their child had a cold or flu expected a prescription for antibiotics.

The main reasons respondents gave as to why they would ask their doctor for antibiotics when they had a cold or flu were:

  • They just hate being sick (21%).
  • They believe that antibiotics help you get over cold or flu more quickly (17%).
  • They cannot afford to take time off work (11%).
  • Their family relies on them, they don’t have time to be sick (11%).

 

“With NPS MedicineWise MedicineInsight data showing that antimicrobial prescribing is highest during winter, it’s timely for us to again address common misconceptions that unfortunately seem to persist about appropriate use of antibiotics during cold and flu season,” says Dr Weekes.

“One misconception in particular that needs to be overcome is the mistaken belief that antibiotics help you get over a cold or flu more quickly: they don’t.

“Colds, flu and most coughs are caused by viruses. Antibiotics only work on infections caused by bacteria, not those caused by viruses.”

The good news is that of those who did visit a doctor last time they had a cold or flu, 44% of people were expecting advice about how to manage their or their child’s cold or flu symptoms.

“For Australians that do come down with a cold or flu this winter, we are urging them to not ask for antibiotics and to let their doctor know that they only want antibiotics if they are truly necessary.

“It’s crucial that Australians start to realise the steps they take each winter can make a difference when it comes to reducing the spread of antibiotic resistance,” says Dr Weekes.

“The reality is that  because of their overuse and misuse, antibiotics are losing their power. But individuals, through their own actions and choices, can be part of the solution by managing ordinary colds and flu without antibiotics.

“The new AURA Report should be a wake-up call to individuals as well as health professionals to remind us to work together to prevent the spread of antibiotic resistance.”

For prescribers and dispensers, the AURA Report indicates there’s still a way to go in combating demand for antibiotics, she says.

“While it appears that nationally, rates of inappropriate antimicrobial prescribing for upper respiratory tract infections are decreasing, as health professionals we cannot become complacent in the fight against antibiotic resistance,” says Dr Weekes.

Dr Weekes points to MedicineInsight data published in the Report that shows 90% of patients with a recorded diagnosis of acute bronchitis had an antibiotic prescribed.

“While the sample size is relatively small—only 30% of the antibiotic prescribing captured in the report data had an indication noted, and the data was taken from 182 practices in 2014 whereas we now have more than 500 GP practices enrolled in the MedicineInsight program—it still gives a snapshot of areas of prescribing where misconceptions prevail.

“The fact is most otherwise healthy patients with acute bronchitis will get better without an antibiotic, with a Cochrane review from 2014 showing that patients who were given antibiotics for acute bronchitis only got better about 12 hours faster than those who were not.”

GP practices enrolled in the MedicineInsight program currently have access to a MedicineInsight report on their prescribing of antibiotics in upper respiratory tract infection, as well as the option to book a facilitated visit on this report.

“Effective patient communication is key, and to help health professionals maintain their knowledge in this area we have tools available which reflect the latest evidence on antibiotic use and antibiotic resistance this winter, including online courses on antibiotics, updated patient counselling tools on respiratory tract infections, and a clinical e-audit for GPs on management of specific respiratory tract infections,” says Dr Weekes.

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