What’s up, doc?

Aussie GPs are prescribing between four and nine times as many antibiotics as they should be, according to MJA research

Research led by Christopher Del Mar, Professor of Public Health at Bond University, has found an estimated mean of 5.97 million acute respiratory infections cases per year were managed in Australian general practice with at least one antibiotic, equivalent to 230 cases per full-time equivalent GP/year.

Antibiotics are not recommended by the guidelines for acute bronchitis/bronchiolitis, but GPs are prescribing them in 85% of cases.

Similarly, they are not recommended for influenza, but are being prescribed in 11% of cases.

Antibiotics were prescribed more frequently than recommended for acute rhinosinusitis, acute bronchitis/bronchiolitis, acute otitis media, and acute pharyngitis/tonsillitis.

“Had GPs adhered to the guidelines, they would have prescribed antibiotics for 0.65–1.36 million ARIs per
year nationally, or at 11–23% of the current prescribing rate,” the authors write in the Medical Journal of Australia.

“Diagnostic uncertainty — concern by the treating doctor that a serious infection or complications might be
missed — is one potential explanation for this finding,” they suggest.

The authors say their findings are the first to quantify the overprescribing of antibiotics in Australia.

The analysis comes just a few weeks after it was announced the Chief Medical Officer had sent out more than 5000 letters to GPs with the highest prescribing rates.

Australia’s highest antibiotic-prescribing GPs had been targeted with a letter from Chief Medical Officer Professor Brendan Murphy, asking them to curb their prescribing.

Individual letters warning about antibiotic resistance had been sent to the top 30% of antibiotic prescribers based on PBS data, comparing their prescribing with other doctors in the area.

Meanwhile, hospital healthcare professionals have been improving their antimicrobial practices.

A new report released by the Australian Commission on Safety and Quality in Health Care has shown the use of antibiotics in hospitals fell by 7.6% between 2011 and 2015 – ” a sign that efforts to encourage more appropriate use of antibiotics and other antimicrobial drugs is having an effect,” says the Commission.

Hospital pharmacists have been at the frontline ensuring the judicious use of antimicrobials to curb rising antimicrobial resistance, said SHPA Acting CEO Andrew Matthews.

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