20 November 2014
NPS MEDICINEWISE REDUCING ANTIBIOTIC RESISTANCE PROGRAM: URINARY TRACT INFECTIONS—EXPLORING ANTIBIOTIC TREATMENT
The next phase of the NPS MedicineWise Reducing Antibiotic Resistance program for health professionals has launched today focused on the complex topic of managing urinary tract infections (UTIs). An interactive case study and the latest issue of Medicinewise News—which contains an insert that discusses the management of UTIs in aged-care facility residents—are now available.
UTIs are common bacterial infections in adults and are seen in both hospital and community settings. Women have a one-in-three chance of developing a urinary tract infection in their lifetime, which is about 50 times more than for men. The likelihood of experiencing a UTI increases with age in both men and women.
UTIs can cause distressing symptoms and antibiotic treatment is usually indicated. Escherichia coli (E. coli) bacteria—known to cause between 80% and 90% of uncomplicated UTIs—has been highlighted by the World Health Organization (WHO) as a bacteria of concern because of growing levels of antibiotic resistance worldwide. E. coli now displays resistance rates to over 50% of commonly used antibiotics.
“Research has shown that when people in the community are prescribed antibiotics to treat a UTI, the bacteria in their bodies may develop resistance to antibiotics that can persist for up to 12 months,” says NPS MedicineWise clinical adviser Dr Philippa Binns. “This can then lead to an increased number of people carrying bacteria that are resistant to first-line antibiotics which can be spread to family members and throughout the community, as well as an increased likelihood that second-line antibiotics will need to be used within the community setting.”
The new interactive NPS MedicineWise case study: Urinary tract infections – exploring antibiotic treatment is now available online and provides a real life clinical scenario with expert commentary from leading infectious diseases physician and microbiologist, Dr Tony Korman from Monash University and questions to help participants focus on their clinical decision making.
“The case study about an 82-year-old woman highlights using antibiotics responsibly, and reinforces health professional knowledge on the risk to patient safety posed by antibiotic resistance,” says Dr Binns.
Case study participants receive instant feedback and are able to compare their approach with their peers. The case study can be completed on a computer, tablet or smart phone, and participants can switch seamlessly between devices. Several key concepts are covered, including:
* Diagnosing urinary tract infections (UTIs)
* Managing asymptomatic bacteriuria
* Identifying empirical treatment and alternative management for UTIs
* Identifying non-pharmacological interventions
* Recurrent UTI prophylaxis.
NPS MedicineWise case studies are free and offer continuing professional development (CPD) points for GPs, pharmacists and nurses. For GPs, the case study is recognised for the Practice Incentives Program Quality Prescribing Incentive.
For more information about the case study, visit www.nps.org.au/casestudy
Also available is the December edition of Medicinewise News. The latest issue provides an evidence-based perspective on reducing antibiotic resistance and managing UTIs. To access Medicinewise News online, visit www.nps.org.au/medicinewise-news
Further products from NPS MedicineWise on UTIs and reducing antibiotic resistance will launch early in 2015, including a Webstercare report for aged care facilities and an online learning module. For more information visit the NPS MedicineWise knowledge hub at www.nps.org.au/utis
19 November 2014
ANTIBIOTIC AWARENESS WEEK 2014: COULD YOUR INDIVIDUAL PRESCRIBING DECISIONS BE CONTRIBUTING TO ANTIBIOTIC RESISTANCE?
Recent evaluation research* conducted by NPS MedicineWise shows that many general practitioners continue to prescribe antibiotics to meet patient expectations, even when antibiotics are not indicated.
The research reveals a communication gap exists between GPs and patients, with GPs overestimating the proportion of patients who expect an antibiotic to be prescribed. Many GPs do not consider that their individual prescribing of antibiotics as a significant contributor to antibiotic resistance and do not feel compelled to change their prescribing practices.
NPS MedicineWise CEO, Dr Lynn Weekes, says that this Antibiotic Awareness Week the research serves as a timely reminder that all Australians urgently need to take action to change the course of antibiotic resistance.
“One of our core messages this Antibiotic Awareness Week is that there are immediate health issues and personal consequences of antibiotic resistance for all Australians,” says Dr Weekes.
“Patient expectations are cited as the main reason for inappropriate prescribing, but it’s clear there is still a prevalent culture of overprescribing and norms that lead to the continuation of these practices.”
“Our research suggests that some GPs don’t believe their individual prescribing makes a difference to antibiotic resistance, however antibiotic prescribing in primary care is contributing to the problem. Every GP can take action to help reduce antibiotic resistance.”
In the recent NPS MedicineWise National GP survey, 57% of participating GPs self reported they would prescribe antibiotics to patients presenting with upper respiratory tract infections to meet their expectations.
Delayed prescribing was also reported to be widely used with antibiotics, with the most common reason for issuing a delayed prescription to satisfy patients seeking an antibiotic. This is often considered a compromise for patients who are considered to be very demanding or anxious, or provided as a safety net for the patient to cover the weekend in case their condition deteriorates.
“What is indicated by the research is that consumers for the most part don’t understand the reasons for delayed prescribing and will go ahead and fill the prescription regardless of the doctor’s instructions,” says Dr Weekes.
“With around 20% of surveyed consumers reporting they would expect antibiotics for a cold or flu, and 17% saying they would ask a doctor to prescribe antibiotics, patient pressure is clearly a contributing factor to inappropriate prescribing.”
Many consumer respondents expected antibiotics to help them feel better and to prevent a potential deterioration of illness, and some believed there will be stronger types of antibiotics they can switch to later if they need to. Another key theme is that while many understand they shouldn’t take antibiotics all the time including for viral infections, they believe antibiotics “work on them” which is a difficult misconception to address.
“Australia is contributing to the problem of antibiotic resistance with one of the highest rates of antibiotic use in the world,” says Dr Weekes.
“We all (health professionals and patients) have a key role to play in shifting the current culture of overprescribing to one where antibiotics are used judiciously and appropriately and with consideration of the growing problem of antibiotic resistance.”
This Antibiotic Awareness Week, NPS MedicineWise is calling on all health professionals and consumers to pledge to fight antibiotic resistance at www.nps.org.au/join-the-fight or at www.facebook.com/NPSMedicineWise.
19 NOVEMBER 2014
ANTIBIOTIC AWARENESS WEEK 2014: URGENT ACTION NEEDED FROM DOCTORS AND PATIENTS TO CURB ANTIBIOTIC RESISTANCE IN AUSTRALIA
To coincide with Global Antibiotic Awareness Day on Tuesday 18 November 2014, NPS MedicineWise is releasing insights from recent research which shows that misconceptions about antibiotics continue to drive inappropriate patient and doctor behaviour, contributing to the growing problem of antibiotic resistance.
Recent evaluation research* conducted by NPS MedicineWise shows that patient expectations lead many general practitioners to prescribe antibiotics when they may not be effective.
The research indicates that more than half of GPs (57%) self reported that they would prescribe antibiotics for an upper respiratory tract infection to meet patient expectations – and 20% of surveyed consumers reported that they would expect the doctor to prescribe antibiotics for a cold or flu. 17% of surveyed consumers replied that they would ask a doctor to prescribe antibiotics.
NPS MedicineWise CEO, Dr Lynn Weekes, said that many doctors are feeling pressured to meet their patients’ expectations.
“Australians must understand that antibiotics will not work for colds and flu or all infections. They are effective for some bacterial infections, but there are misconceptions in the community that antibiotics will work for most illnesses and this is not the case.
“Our research has found that doctors feel pressured by some people, and this pressure combined with other factors such as time constraints, means they may prescribe antibiotics when it is not appropriate. The overuse and misuse of antibiotics is increasing the problem of antibiotic resistance in Australia.”
Another clear theme emerging from the research is that people don’t understand that what they do as individuals can have a very real and immediate impact on antibiotic resistance.
“There is a misconception that this is a problem one has no control over, and therefore action at an individual level makes no difference,” says Dr Weekes.
“We are seeing that some doctors don’t believe their individual prescribing makes a difference, and patients believe this is an issue for future generations and therefore they won’t bear the consequences. The reality is that antibiotic resistance is a personal threat now, it’s a growing problem in our community, and to prevent it we all need to take personal action.”
The more antibiotics are used, the more chances bacteria have to become resistant to them. This can then make bacterial infections much harder to treat.
“Using antibiotics when you don’t need them may mean that they won’t work for you when you do need them in the future,” says Dr Weekes.
Dr Weekes outlined some tips for all Australians to help prevent antibiotic resistance:
* Don’t pressure doctors to prescribe antibiotics for you when they’re not required
* When you do need to take antibiotics, take them exactly as prescribed
* Never save leftover antibiotics for another illness or another person’s use
* Practise good hygiene (such as regular hand washing) to avoid infections and prevent them spreading to others.
This Antibiotic Awareness Week, NPS MedicineWise is calling on all Australians consumers and health professionals to pledge to join the fight antibiotic resistance at www.nps.org.au/join-the-fight or at www.facebook.com/NPSMedicineWise.