Key points
- Antibiotic resistance is impacting us now – we all have a role to play.
- Avoid routine prescribing of antibiotics in upper respiratory tract infections and acute bronchitis as they are of limited benefit, and cause harm.
- Avoid testing urine in patients older than 65 years, unless there are clear symptoms of a urinary tract infection (UTI).
Choosing Wisely Australia
Choosing Wisely Australia helps healthcare providers and consumers have important conversations about improving the quality of healthcare by reducing unnecessary and sometimes harmful tests, treatments, and procedures.
Led by Australia’s colleges, societies and associations and facilitated by NPS MedicineWise, Choosing Wisely Australia challenges the way we think about healthcare, questioning the notion 'more is always better'.
5 questions to ask your doctor or other healthcare provider is a resource that can help patients ensure they end up with the right amount of care.
See the Choosing Wisely recommendations on antibiotics
Recommendation from the Society of Hospital Pharmacists of Australia
Recommendation from Australasian Society for Infectious Diseases
Australian Prescriber: 2018 Aged Care National Antimicrobial Prescribing Survey results show room for improvement
Leslie Dowson, Arjun Rajkhowa, Kirsty Buising, David CM Kong, Rhonda L Stuart, Karin Thursky, Noleen Bennett
Aust Prescr 2019 Early release 14 November 2019
DOI: 10.18773/austprescr.2019.066
The annual Aged Care National Antimicrobial Prescribing Survey aims to identify local and national prescribing issues and guide antimicrobial stewardship goals.
In the 2018 point prevalence survey, medication charts of over 20,000 residents were reviewed from 407 participating facilities across Australia.
On the day of the survey, almost 10% of residents were prescribed an antimicrobial.
Nearly two-thirds of recently prescribed antimicrobials were for residents who had no documented signs or symptoms of infection.
Over a quarter of antimicrobials had been prescribed for longer than six months.
Antibiotic prescribing in primary care
This freely available table from Therapeutic Guidelines provides an up-to-date summary of first-line treatment options for the management of common conditions in primary care.
More detailed information including second-line treatment options and management of special patient groups (eg penicillin hypersensitivity, renal impairment), can be found in eTG complete.
World Antimicrobial Awareness Week 18–24 November
World Antimicrobial Awareness Week is an annual, global event that raises awareness about the serious health issue of antibiotic resistance.
This year, we're urging people that it's time to take antibiotic resistance seriously.
NPS MedicineWise has information for consumers and for health professionals to raise awareness about antibiotic resistance and help preserve the power of antibiotics.
Sometimes, parents need reassurance rather than antibiotics
When their children are unwell, parents and carers often visit their GP for reassurance. They want to check their child doesn’t have a serious illness and have the opportunity to discuss what is worrying them about their child’s cold, cough, earache or sore throat.
The Childhood RTI Fact Sheet: What every parent should know can help you reassure parents.
Antimicrobial use and resistance in Australia: keeping Australia informed and prepared
In 2014, at least one course of antibiotics was dispensed to 46% of Australians. Antimicrobial use is a key driver of antimicrobial resistance – the more we use antimicrobials, the more likely it is that resistance will develop. Appropriate use of antimicrobials can be life-saving, but inappropriate use needs to be minimised to prevent and contain antimicrobial resistance.
Find out more about antimicrobial use and resistance in Australia
MedicineWise News: Taking a bite out of antibiotic resistance
Skin and soft tissue are significant sources of MRSA in the community. Bite and clenched fist injuries are a common cause of skin infections, but may not require antibiotics.
Find out more about ways to manage bite injuries without unnecessary use of antibiotics.
Antibiotic resistance in Australia: here and now
Antibiotic resistance is not only emerging to more frequently used antibiotics such as penicillins, but also to ‘reserve’ antibiotics such as vancomycin and meropenem. Rates of resistance for some Gram-positive bacteria are higher in Australia compared with rates in other countries.
Prescribing data indicate that antibiotics are frequently prescribed in situations that are not consistent with evidence-based guidelines, and the antibiotic type being prescribed is sometimes not optimal. Moderate or broad-spectrum antibiotics are being prescribed more often than narrow-spectrum agents.
COPD and antibiotics
Most respiratory tract infections, such as colds and flu, are caused by viruses. If you are generally healthy and well, your body can fight the virus and get better without any treatment. Taking antibiotics won’t help, because antibiotics don’t kill viruses.
However, if you have long-term lung problems, such as chronic obstructive pulmonary disease (COPD), you may be at a higher risk of complications from a cold, flu or other respiratory tract infection (eg, a second infection caused by bacteria). In these circumstances, antibiotics may be an appropriate treatment for you.
CPD options
Consolidate your knowledge about antibiotic resistance, brush up on current guidelines and practices and earn CPD points through our learning activities
For GPs:
- Online Case Study: Urinary tract infections – exploring antibiotic treatment
- Online Case Study: Otitis media – clarifying the role of antibiotics
- Online Course: Introduction to antimicrobial prescribing
For pharmacists:
- Online Course: Antimicrobials – catheter-associated urinary tract infections
- Online Course: Antimicrobials – bacteraemia
- Online Case Study: Urinary tract infections – exploring antibiotic treatment
- Online Course: Antimicrobials: community-acquired pneumonia
- Online Course: Antimicrobials – surgical prophylaxis
- Online Course: Managing UTIs in aged care
- Online Case Study: Otitis media – clarifying the role of antibiotics
- Online Case Study: Urinary tract infections – exploring antibiotic treatment
For nurses:
- Online Course: Antimicrobials – catheter-associated urinary tract infections
- Online Course: Antimicrobials – bacteraemia
- Online Case Study: Urinary tract infections – exploring antibiotic treatment
- Online Course: Antimicrobials – community-acquired pneumonia
- Online Course: Antimicrobials: surgical prophylaxis
- Online Course: Managing UTIs in aged care
- Online Case Study: Urinary tract infections – exploring antibiotic treatment
- Online Case Study: Otitis media: clarifying the role of antibiotics
Respiratory Tract Infection Action Plan
Use the RTI Action Plan to discuss symptom management of uncomplicated respiratory tract infections with your patients. The RTI Action Plan is available below as an editable PDF and in your medical software. This can be printed and filled out in the medical practice.
Find out more about how to access NPS resources in your clinical software.
Translated information about antibiotic resistance
Childhood RTI Fact Sheet: What every parent should know
Providing reassurance to consumers about the expected duration of symptoms and how to identify signs and symptoms of more serious illness may assist in managing expectations for antimicrobials. Use the Childhood RTI Fact Sheet: What every parent should know to help reassure parents.
5 Questions to ask your doctor or other healthcare provider
Choosing Wisely Australia helps healthcare providers and consumers have important conversations about improving the quality of healthcare by reducing unnecessary and sometimes harmful tests, treatments, and procedures.
Led by Australia’s colleges, societies and associations and facilitated by NPS MedicineWise, Choosing Wisely Australia challenges the way we think about healthcare, questioning the notion 'more is always better'.
5 questions to ask your doctor or other healthcare provider is a resource that can help patients ensure they end up with the right amount of care.
Research summary
Antimicrobial use and resistance in Australia
Antibiotic prescribing in respiratory tract infections
- Venekamp RP, Sanders SL, Glasziou PP, Del Mar CB, Rovers MM. Antibiotics for acute otitis media in children. Cochrane Database Syst Rev 2015;6:CD000219. DOI: 10.1002/14651858.CD000219.pub4
- Smith SM, Fahey T, Smucny J, Becker LA. Antibiotics for acute bronchitis. Cochrane Database Syst Rev 2014;3:CD000245. DOI: 10.1002/14651858.CD000245.pub3
- Kenealy T, Arroll B. Antibiotics for the common cold and acute purulent rhinitis. Cochrane Database Syst Rev 2013;6:CD000247. DOI: 10.1002/14651858.CD000247.pub3.
- Coxeter PD, Del Mar C, Hoffmann TC. Parents’ Expectations and Experiences of Antibiotics for Acute Respiratory Infections in Primary Care. Ann Fam Med 2017;15:149-154.
- Gulliford, MC, Moore MV, Little P, Hay AD, Fox R, et al. Safety of reduced antibiotic prescribing for self-limiting respiratory tract infections in primary care: cohort study using electronic health records. BMJ 2016;354:i3410.