A national report has found COVID has caused one of the biggest drops in antibiotic use in Australia in decades, but fears remain the country is “losing the war” against drug-resistant infections.
- New report reveals decline in antibiotic use in Australia
- But concerns remain about antimicrobial resistance
- AMA chief says we’re in a race against time to stop drug-resistant microbes from getting worse.
While the Australian Commission on Safety and Quality in Healthcare report found community antibiotic use had fallen by 19% since 2019, the country was one of the largest users in the world.
The main problems are the unwanted side effects of antibiotics, as well as the rise of several dangerous bacteria that are becoming increasingly resistant to antibiotic treatments, making it more difficult to treat serious infections.
Antimicrobial resistance occurs when a microorganism develops resistance to an antimicrobial that was previously an effective treatment.
In Australia, hundreds of people die from it every year.
COVID led to a drop in prescriptions
The report reveals that 21.8 million antimicrobial prescriptions were dispensed in the community in 2022, compared to 26.6 million in 2017.
The commission’s principal medical adviser, John Turnidge AO, said the pandemic had had a powerful impact.
“COVID had a profound effect on the amount of antibiotics we were using more than any other intervention we have done in the last 20 years,” Professor Turnidge said.
“People were cooped up or not going to their doctors, they weren’t getting viral infections either, so they weren’t going to the doctor and getting antibiotics inappropriately.”
Antibiotic use rebounds
However, the report notes a 10% increase in community antimicrobial use in 2022.
That year, one in three Australians received at least one round of antibiotics.
The report highlights that many of the problems with antimicrobial prescribing occur in hospital settings, with 23 per cent of hospital prescribing deemed inappropriate.
The study also found that 80 percent of cases of acute bronchitis in the community were given antibiotics, despite no evidence of benefit, and that 35 percent of drugs administered in aged care facilities were “at risk.” preventive measure.
Professor Turnidge said Australia had a window of opportunity to continue to build on the downward trend that occurred during COVID.
“Historically, many antibiotics have been used to treat respiratory infections, and 99 percent are caused by viruses,” Professor Turnidge said.
“It’s this uncertainty about diagnosis that has caused this situation over the last 50 years, and it takes a long time to convince people ‘you don’t need antibiotics if you have a virus ‘.
“No one asked for antibiotics when they got COVID, so maybe we can apply this to flu, coughs, colds and sore throats as well.”
Common pathogens such as Staphylococcus aureus, Escherichia coli and Neisseria gonorrhoeae are highlighted in the report as becoming increasingly resistant to major drugs.
The report says Australia ranks seventh behind European countries, the United Kingdom and Canada in terms of community antimicrobial use.
Highest usage in Queensland, New South Wales and Victoria
Based on 2022 PBS data, the report found antimicrobial use was highest in Queensland, New South Wales and Victoria.
But lower rates of antimicrobial use were seen in 2020 and 2021 compared to previous years in all states and territories.
Australian Medical Association (NSW) president Dr Michael Bonning said antibiotics were seen as a “panacea” but were a “race against time for us as humans”.
“We are losing the war against drug-resistant infections,” he said.
“Most patients underestimate the effects of drug-resistant infections, thinking there is always another drug in the toolbox to save them and that toolbox gets emptier and emptier over time.”
- Community antibiotic use has fallen 18 percent since 2019
- One in three Australians received at least one round of antibiotics in 2022
- 23 percent of hospital prescriptions in 2022 were inappropriate
- 80 percent of community-acquired acute bronchitis cases receive antibiotics despite lack of benefit
- 35 percent of scenarios in elderly care were preventative
For individuals, he explained that avoiding antibiotics came down to hygienic practices and rest when sick.
“We wash our hands, we think about how long we store food, we pay attention to expiration dates,” he said.
“Take some time off, give yourself some downtime so you can heal faster… without continuing to spread things around.
“You can’t ask for antibiotics, but someone else might go to a doctor to get antibiotics for something that is otherwise viral.”
He said education was essential.
“As a community we want to provide some support to GPs, we want the government to advertise nationally and discuss when antibiotics are appropriate, so that it is not just GPs who are holding back the tide of individuals who might be concerned and want antibiotics.” says Dr. Bonning.
“Everyone needs reinforcements, and that’s what we need the most help for.
“Your immune system is the thing we need to support at the right time to ensure you get better.”
Professor Turnidge said probiotics were not as powerful as previously thought in helping to bring good bacteria back into the body.
“The way to think about it is that antibiotics will damage your good bugs,” he said.
“Running around trying to replace it with yogurt won’t do it.
“We must save antibiotics, they are precious.”