NPS Media Releases – 1. Survey finds Australian Millennials confused about antibiotics 2. Surgical antimicrobial prophylaxis: preventing infection or increasing resistance? 3. Evidence-based not-for-profit plays vital role in reducing antibiotic resistance

1. Survey finds Australian Millennials confused about antibiotics
13 November 2017

Many young Australians are asking for antibiotics when they don’t need them, according to new research released by independent not-for-profit NPS MedicineWise during World Antibiotic Awareness Week (13-19 November 2017). 

 Many young Australians are asking for antibiotics when they don’t need them, according to new research released by independent not-for-profit NPS MedicineWise during World Antibiotic Awareness Week (13-19 November 2017).

The national survey* of more than 2,500 people revealed that over one-third (35%) of 16- to 24-year-olds ask their health professionals for antibiotics when they have colds or flu. The results indicate that younger Australians may be unaware that antibiotics are ineffective for these common viral infections.

Respondents over the age of 75 are the least likely Australians to ask for antibiotics when they’re not needed, with just 13% saying they’d ask for these medicines to treat a cold or flu.

The survey found that requests for antibiotics to combat a cold or flu generally decrease with age: 14% of 65- to 74-year-olds would ask, followed by people aged 55 to 64 (17%), 45 to 54 (19%), 35 to 44 (20%) and 25 to 34 (27%).

NPS MedicineWise Medical Adviser, Dr Andrew Boyden said: “This research shows many young people appear to lack knowledge about antibiotics and their purpose.

“Unless the excessive use of antibiotics in our community can be dramatically curbed, unfortunately it will be the younger generations who will be more exposed to antibiotic resistance as time goes on.

“We need to raise awareness, particularly in younger people, that antibiotics are a precious resource which are ineffective for the treatment of viruses, and should be reserved for the treatment of bacterial infections.”

“However, this problem isn’t isolated to only young people — our survey also suggested that that 4 in every 10 Australians would ask their GP for an antibiotic to treat their cold or flu.”

Dr Boyden added that the World Health Organization has warned antibiotic resistance is one of the greatest threats to human health today, and is making it increasingly difficult to treat bacterial infections.

*The survey of 2,509 Australians was conducted by NPS MedicineWise in June 2017.

Got a question about your medicines? Call Medicines Line on 1300 633 424 (1300 MEDICINE) to speak with a health professional Monday to Friday 9am to 5pm AEST (excluding NSW public holidays)

2. Surgical antimicrobial prophylaxis: preventing infection or increasing resistance?
14 November 2017

Using antibiotics to prevent surgical site infections is the most common indication for antimicrobial use in Australian hospitals. However, there are high rates of inappropriate use.

40% of prescriptions for surgical prophylaxis were found to be inappropriate in the 2015 National Antimicrobial Prescribing Survey. This is problematic because it contributes to overuse of antibiotics, and exposes patients to potential adverse effects.

During World Antibiotic Awareness Week (13–19 November), a special release article from Australian Prescriber urges health professionals to conserve the usefulness of antibiotics by practising appropriate antimicrobial prescribing during surgery.

One of the authors, Professor Karin Thursky, Director of the National Centre for Antimicrobial Stewardship, says a common finding is that patients are continued on oral antibiotics after surgery. There may be several reasons for this, but it may be driven by individual surgeons’ beliefs that it helps reduce risk of infection.

“All surgical procedures carry a risk of infection. There is good evidence for how and when antibiotics are required to prevent post-surgical infection. What we are seeing though is a wide variation in practice which may not provide any additional benefit to the patient, and may in fact cause harm. Use of any antibiotics must be balanced against their potential risks, including allergic reactions, antibiotic-associated Clostridium difficile and antibiotic resistance,” says Professor Thursky.

“For minor procedures undertaken in general practice, prophylaxis before or during surgery is often not indicated and post-procedural prophylaxis, especially the use of topical antimicrobials, is rarely indicated yet often prescribed.”

“Antimicrobial prophylaxis is more likely to be needed for procedures where surgical site infections tend to be high, such as colorectal surgery, or where the consequences of infection are significant (eg cardiac valve surgery).”

The authors urge that efforts need to be made to maximise the quality of surgical antimicrobial prophylaxis prescribing in accordance with the Therapeutic Guidelines or locally endorsed prophylaxis guidelines.

In a more recent survey (2016) specifically looking at surgical antimicrobial prophylaxis, there were concerns about inappropriate procedural and post-procedural prescribing in Australian hospitals. Where guidelines were available, 41% of procedural and 62% of post-procedural prophylaxis was not concordant with those guidelines.

The key elements of appropriate prophylaxis include considering the correct indication, antimicrobial, drug dose, route, timing of administration and duration.

“It’s important for GPs to remember they have a significant role to play in ensuring the appropriate use of antibiotics. Patients are usually back into the community after their operation or procedure, and GPs will manage their post-operative progress. Understanding the role of antibiotics in the absence of a documented infection is important,” Professor Thursky points out.

6 ways to achieve best-practice surgical antimicrobial prophylaxis in general practice

  1. Do not prescribe surgical antimicrobial prophylaxis without an appropriate indication.
  2. Avoid topical antimicrobials for surgical procedures.
  3. Use the Therapeutic Guidelines for specific information regarding optimal drug, dose, route and timing.
  4. Query long-term use of post-procedural antibiotics with the initial prescriber or surgical team.
  5. Avoid prescribing ongoing supply of topical and oral antimicrobials without a clear indication from the initial prescriber.
  6. Monitor for surgical complications such as superficial, deep and organ space infections, and discuss with the surgeon or treating hospital.

For dentists

For dental procedures, guidelines recommend that antimicrobial prophylaxis may be appropriate for surgery on immunocompromised patients, and for surgical removal of a bone-impacted tooth or periapical surgery in patients with a history of recurring infections.

Endocarditis prophylaxis may be required for a range of dental procedures in specific patients.

To read more about antibiotic prophylaxis in dentistry, see the article in the current issue of Australian Prescriber.

3. Evidence-based not-for-profit plays vital role in reducing antibiotic resistance
16 November 2017

NPS MedicineWise educational programs have been associated with reduced monthly antibiotic dispensing volume, according to new research conducted by the not-for-profit organisation.

The research shows the dispensing of selected antibiotics commonly prescribed for upper respiratory tract infections has been reduced by 14%-19% between 2009 and 2015. Surveys have found that GPs who participated in the programs have changed their attitudes, prescribing behaviour and advice to patients. 

GPs who actively participated in NPS MedicineWise educational interventions, compared to GPs who did not, reported increases in: 

  • knowledge about antibiotic resistance (87% vs 64%)
  • discussion of hand hygiene with patients (90% vs 82%), and 
  • guideline use (96% vs 88%).

Dr Lynn Weekes says this shows GPs are committed to the judicious use of antibiotics, and with appropriate tools, are helping to reduce antimicrobial resistance.

These results were recently presented at the GP17 conference in Sydney and have been released as part of World Antibiotic Awareness Week (13-19 November), indicating GPs have responded positively to national antibiotic resistance education programs, with reduced prescribing in primary care.

“Antibiotic resistance is a serious public health threat with far-reaching consequences,” Dr Weekes says.

“The 2016 AURA report highlights there is still an inappropriate prescribing of antibiotics across all health settings, and more needs to be done to address the problem.

“GPs often feel pressured by their patients to prescribe antibiotics for URTIs. This is why it’s important to reach prescribers, as well as the community, about the issue. By reducing the demand for unnecessary antibiotics, we can reduce the number of avoidable prescriptions.”

Dr Weekes also notes the World Health Organization has declared antibiotic resistance to be one of the greatest threats to human health today.

“While progress has been made, the fight against antibiotic resistance is far from over. Ongoing strategies to reach GPs and consumers are vital in order to sustain continual reductions in antibiotic use. We need to keep working hard to reduce antibiotic resistance,” Dr Weekes adds.


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