Antimicrobial resistance still on the rise: new report

A new report released today shows that overall use of antibiotics in the community fell between 2015 and 2017 – the first decline in 20 years.

However, the Third Australian report on antimicrobial use and resistance in human health, revealed that antimicrobial resistance is on the rise as antibiotics are continually over-prescribed.

The report was conducted by the Antimicrobial Use and Resistance in Australia (AURA) Surveillance System, which was developed by the Australian Commission on Safety and Quality in Health Care with the aim of supporting prevention and containment of antimicrobial resistance.

In 2017, total hospital antibiotic use rose for the first time since 2013, while “inappropriate” prescriptions of antibiotics in hospitals remained steady from the 2013 stats, at 23.5 per cent of all prescriptions.

The five most commonly prescribed antibiotics in the hospitals that participated in the study were amoxicillin-clavulanic acid, cefazolin, flucloxacillin, doxycycline and amoxicillin. Cefalexin and amoxicillin-clavulanic acid were found to have had the highest rates of inappropriate prescriptions.

The most common ailments recorded for prescriptions of antibiotics in hospitals were surgical prophylaxis, community-acquired pneumonia, medical prophylaxis, urinary tract infections and sepsis.

In primary care, antibiotic prescriptions declined between 2016 and 2017, the first such decline since the 1990s.

However, Australia’s use of antibiotics in the community remains incredibly high, sitting in the top 25 per cent of countries. In 2017, 41.5 per cent of the nation had at least one systemic antibiotic dispensed to them.

AURA found that people were prescribed antibiotics for conditions for which there is no evidence of benefit, including influenza (52.2 per cent of patients with this condition recorded) and acute bronchitis (92.4 per cent of patients with this condition recorded).

The figures for aged care homes are also concerning.

The report said that “aged care homes in Australia have high levels of both unnecessary antimicrobial prescribing and inappropriate antimicrobial use,” with at least one in 10 residents of participating homes prescribed at least one antimicrobial, and “more than half of antimicrobial prescriptions were for residents who had no signs or symptoms of infection”.

Kathryn Daveson, AURA clinical director, said: “While the downward shift in prescribing will help to slow the spread of resistance, these latest AURA findings indicate that the levels of inappropriate prescribing of antibiotics in hospitals and the community are still too high and there is more work to be done.”

John Turnidge, the Commission’s senior medical advisor, said the AURA research is key to fighting antimicrobial resistance.

“The expanded AURA Surveillance System allows us to identify and track national trends in antimicrobial use and antimicrobial resistance, and monitor the effect of changes in policy and clinical practice, to a level that has not previously been possible,” he said.

The full report can be found here.

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