The Times Australia
The Times World News

.

No, antibiotics aren't always needed. Here's how GPs can avoid overprescribing

  • Written by Mina Bakhit, Assistant Professor of Public Health, Bond University
No, antibiotics aren't always needed. Here's how GPs can avoid overprescribing

Antimicrobial resistance is one of the biggest global threats[1] to health, food security and development. This month, The Conversation’s experts explore how we got here and the potential solutions[2].

The growth in antibiotic resistance threatens to return the world to the pre-antibiotic era – with deaths from now-treatable infections, and some elective surgery being restricted because of the risks of infection.

Antibiotic resistance is a major problem worldwide and should be the concern of everyone, including you.

We need to develop new antibiotics that can fight the resistant bacteria or antibiotics that bacteria would not be quickly resistant to. This is like finding new weapons to help the immune system fight the bacteria.

More importantly, we need to use our current antibiotics – our existing weapons against the bacteria – more wisely.

Read more: Could new antibiotic clovibactin beat superbugs? Or will it join the long list of failed drugs?[3]

Giving GPs the tools to say no

In 2022, more than one-third of Australians[4] had least one antibiotic prescription, with 88%[5] of antibiotics prescribed by GPs.

Many people mistakenly think[6] antibiotics are necessary for treating any infection and that infections won’t improve unless treated with antibiotics. This misconception is found in studies involving patients with various conditions, including respiratory infections and conjunctivitis.

In reality, not all infections require antibiotics, and this belief drives patients requesting antibiotics from GPs.

Other times, GPs give antibiotics because they think patients want them, even when they might not be necessary. Although, in reality they are after symptom relief[7].

For GPs, there are ways to target antibiotics for only when they are clearly needed, even with short appointments with patients perceived to want antibiotics. This includes:

All these strategies need some training[8] and practice, but they can help GPs prescribe antibiotics more responsibly. GPs can also learn from each other and use tools like posters[9] as reminders.

To help with patients’ expectations, public campaigns have been run periodically to educate people about antibiotics. These campaigns explain why[10] using antibiotics too much can be harmful and when it’s essential to take them.

Giving doctors feedback on their prescribing

National programs and interventions can help GPs use antibiotics more wisely

One successful way they do this is by giving GPs feedback[11] about how they prescribe antibiotics. This works better when it’s provided by organisations that GPs trust, it happens more than once and clear goals are set for improvement.

GP types on laptop
GPs tend to act on feedback about their antibiotic prescribing. Shutterstock[12]

The NPS (formerly National Prescribing Service) MedicineWise program, for example, had been giving feedback to GPs on how their antibiotic prescriptions compared to others. This reduced the number of antibiotics prescribed.

However, NPS no longer exists[13].

In 2017, the Australian health department did something similar by sending feedback letters[14], randomly using different formats, to the GPs who prescribed the most antibiotics, showing them how they were prescribing compared to others.

The most effective letter, which used pictures to show this comparison, reduced the number of antibiotics GPs prescribed by 9% in a year[15].

Read more: How do bacteria actually become resistant to antibiotics?[16]

Clearer rules and regulations

Rules and regulations are crucial in the fight against antibiotic resistance.

Before April 2020, many GPs’ computer systems made it easy to get multiple repeat prescriptions for the same condition, which could encourage their overuse.

However, in April 2020, the Pharmaceutical Benefits Scheme (PBS) changed the rules[17] to ensure GPs had to think more carefully about whether patients actually needed repeat antibiotics. This meant the amount of medicine prescribed better matched the days it was needed for.

Pharmacist looks at antibiotics
Simple changes can make a difference to antibiotic prescribing and dispensing. Shutterstock[18]

Other regulations or policy targets could include:

  • ensuring all GPs have access to antibiotic prescribing guidelines, such as Therapeutic Guidelines[19], which is well accepted and widely available in Australia

  • ensuring GPs are only prescribing antibiotics when needed. Many of the conditions antibiotics are currently prescribed for (such as sore throat, cough and middle ear infections) are self-limiting, meaning they will get better without antibiotics

  • encouraging GP working with antibiotics manufacturers to align pack sizes to the recommended treatment duration. The recommended first-line treatments for uncomplicated urinary tract infections in non-pregnant women, for example, are either three days of trimethoprim 300 mg per night or five days of nitrofurantoin 100 mg every six hours. However, the packs contain enough for seven days. This can mean patients take it for longer or use leftovers later.

Australia lags behind Sweden

Australia has some good strategies for antibiotic prescribing, but we have not had a sustained long-term plan to ensure wise use.

Although Australian GPs have been doing well in reducing antibiotic prescribing[20] since 2015, more[21] could be done.

In the 1990s, Sweden’s antibiotic use was similar to Australia’s, but is now less than half. For more than two decades, Sweden has had a national strategy that reduces antibiotic use by about 7% annually[22].

Read more: We can reverse antibiotic resistance in Australia. Here's how Sweden is doing it[23]

It is vital Australia invests in a similar long-term national strategy – to have a centrally funded program, but with regional groups working on the implementation. This could be funded directly by the Commonwealth Department of Health and Ageing, or with earmarked funds via another body such as the Australian Centre for Disease Control.

In the meantime, individual GPs can do their part to prescribe antibiotics better, and patients can join the national effort to combat antibiotic resistance by asking their GP: “what would happen if I don’t take an antibiotic?”.

Read the other articles in The Conversation’s series on the dangers of antibiotic resistance here[24].

References

  1. ^ one of the biggest global threats (www.who.int)
  2. ^ explore how we got here and the potential solutions (theconversation.com)
  3. ^ Could new antibiotic clovibactin beat superbugs? Or will it join the long list of failed drugs? (theconversation.com)
  4. ^ one-third of Australians (www.safetyandquality.gov.au)
  5. ^ 88% (www.safetyandquality.gov.au)
  6. ^ mistakenly think (pubmed.ncbi.nlm.nih.gov)
  7. ^ after symptom relief (pubmed.ncbi.nlm.nih.gov)
  8. ^ training (www.nps.org.au)
  9. ^ posters (pubmed.ncbi.nlm.nih.gov)
  10. ^ explain why (pubmed.ncbi.nlm.nih.gov)
  11. ^ giving GPs feedback (pubmed.ncbi.nlm.nih.gov)
  12. ^ Shutterstock (www.shutterstock.com)
  13. ^ NPS no longer exists (australianprescriber.tg.org.au)
  14. ^ feedback letters (behaviouraleconomics.pmc.gov.au)
  15. ^ 9% in a year (behaviouraleconomics.pmc.gov.au)
  16. ^ How do bacteria actually become resistant to antibiotics? (theconversation.com)
  17. ^ changed the rules (www.pbs.gov.au)
  18. ^ Shutterstock (www.shutterstock.com)
  19. ^ Therapeutic Guidelines (www.tg.org.au)
  20. ^ reducing antibiotic prescribing (www.safetyandquality.gov.au)
  21. ^ more (pubmed.ncbi.nlm.nih.gov)
  22. ^ 7% annually (www.ncbi.nlm.nih.gov)
  23. ^ We can reverse antibiotic resistance in Australia. Here's how Sweden is doing it (theconversation.com)
  24. ^ here (theconversation.com)

Read more https://theconversation.com/no-antibiotics-arent-always-needed-heres-how-gps-can-avoid-overprescribing-213981

Times Magazine

Building a Strong Online Presence with Katoomba Web Design

Katoomba web design is more than just creating a website that looks good—it’s about building an online presence that reflects your brand, engages your audience, and drives results. For local businesses in the Blue Mountains, a well-designed website a...

September Sunset Polo

International Polo Tour To Bridge Historic Sport, Life-Changing Philanthropy, and Breath-Taking Beauty On Saturday, September 6th, history will be made as the International Polo Tour (IPT), a sports leader headquartered here in South Florida...

5 Ways Microsoft Fabric Simplifies Your Data Analytics Workflow

In today's data-driven world, businesses are constantly seeking ways to streamline their data analytics processes. The sheer volume and complexity of data can be overwhelming, often leading to bottlenecks and inefficiencies. Enter the innovative da...

7 Questions to Ask Before You Sign IT Support Companies in Sydney

Choosing an IT partner can feel like buying an insurance policy you hope you never need. The right choice keeps your team productive, your data safe, and your budget predictable. The wrong choice shows up as slow tickets, surprise bills, and risky sh...

Choosing the Right Legal Aid Lawyer in Sutherland Shire: Key Considerations

Legal aid services play an essential role in ensuring access to justice for all. For people in the Sutherland Shire who may not have the financial means to pay for private legal assistance, legal aid ensures that everyone has access to representa...

Watercolor vs. Oil vs. Digital: Which Medium Fits Your Pet's Personality?

When it comes to immortalizing your pet’s unique personality in art, choosing the right medium is essential. Each artistic medium, whether watercolor, oil, or digital, has distinct qualities that can bring out the spirit of your furry friend in dif...

The Times Features

From Garden to Gift: Why Roses Make the Perfect Present

Think back to the last time you gave or received flowers. Chances are, roses were part of the bunch, or maybe they were the whole bunch.   Roses tend to leave an impression. Even ...

Do I have insomnia? 5 reasons why you might not

Even a single night of sleep trouble can feel distressing and lonely. You toss and turn, stare at the ceiling, and wonder how you’ll cope tomorrow. No wonder many people star...

Wedding Photography Trends You Need to Know (Before You Regret Your Album)

Your wedding album should be a timeless keepsake, not something you cringe at years later. Trends may come and go, but choosing the right wedding photography approach ensures your ...

Can you say no to your doctor using an AI scribe?

Doctors’ offices were once private. But increasingly, artificial intelligence (AI) scribes (also known as digital scribes) are listening in. These tools can record and trans...

There’s a new vaccine for pneumococcal disease in Australia. Here’s what to know

The Australian government announced last week there’s a new vaccine[1] for pneumococcal disease on the National Immunisation Program for all children. This vaccine replaces pr...

What Makes a Small Group Tour of Italy So Memorable?

Traveling to Italy is on almost every bucket list. From the rolling hills of Tuscany to the sparkling canals of Venice, the country is filled with sights, flavors, and experiences ...