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 cmpelled 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.