‘Time is running out’ on antibiotic misuse, experts say

High rates of antibiotic misuse in Australian care facilities have raised concerns over the ongoing threat of antimicrobial resistance.

A new analysis of 39 countries found that almost 70 per cent of residents in Australia are prescribed antibiotics annually, compared to 54 per cent in the UK and 63 per cent in the Netherlands and North America.

Less than 30 per cent of these prescriptions were deemed to be appropriate. 

“We know in Australia at a national level, antibiotic use is one of the highest compared to all OECD countries,'' said Dr Magda Raban, a senior researcher at the Australian Institute of Health Innovation at Macquarie University.

“We haven’t had a really good snapshot of residential care in Australia compared to other countries until recently.” 

Persistent antibiotic use among the general population is of major global concern, with antimicrobial resistance causing over 700,000 deaths per year. This figure is estimated to reach 10 million by 2050. 

More specific approaches are needed to reduce misuse in aged care due to the prevalence of complex healthcare needs and risks associated with polypharmacy, said Raban.

“Older people have a higher risk of adverse effects from antibiotics.”

“In people who are already on a number of medications, you’ve got an increased risk of adding an antibiotic that could interact with a medication that they are already on.” 

Past reports have flagged antibiotic use as a pressing issue, with the royal commission introducing several quality care initiatives to minimise errors. 

Despite this, inadequate drug prescribing practices continue to drive persistent misuse, according to Raban. 

“The care for older people living in aged care can be quite fragmented, we know GPs are already short on time generally in their practice.

“Facilities are often understaffed, so you might have one nurse for one big facility, so in terms of medication management that process can be quite disjointed.”

Leveraging IT systems to better organise and monitor drug data is an effective solution to reducing antibiotic use, said Raban.  

“Ideally you’d have clinical decision support, that at the time of prescribing and administering medication you’d be able to be prompted if something is not right.

“You want things that will be at real time, that will alert the care providers that something might not be ideal for that person at that certain point in time.

“So being able to effectively use the data that’s captured in their systems is really important.”

Addressing community knowledge around antibiotics will also be key to slowing the spread of antimicrobial resistance. 

While data on family and residents attitudes are unclear, consumer surveys suggest a common assumption that there are minimal risks associated with antibiotic use.

Addressing community knowledge will be key to slowing the spreading of antimicrobial resistance, Raban says. 

“If there’s a perception in the community generally that antibiotics are needed, that people can push for those prescriptions, then we really need to balance out how we inform the community as well as providers, and support providers in antimicrobial stewardship. 

“Because time is running out on antibiotic resistance.”

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