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Antibiotic crackdown overdue says Bond expert

Bond University’s Institute for Evidence-Based Healthcare (IEBH) has welcomed moves to prevent GPs from handing out repeat prescriptions for some antibiotics.

The Pharmaceutical Benefits Advisory Committee (PBAC), which makes recommendations to the federal government, has urged the removal of repeat prescriptions for common ­antibiotics in high usage where they are deemed therapeutically unnecessary.

Repeats would no longer be subsidised under the Pharmaceutical Benefits Scheme and patients would need to return to their doctor for a new script if their infection had not cleared.

Medical doctor and IEBH Postdoctoral Research Fellow Mina Bakhit said the move was important to slowing the rate of antibiotic resistance which the World Health Organisation has identified as one of the biggest threats to global health.

“This move by PBAC is important because there are infections within primary care - for example acute cough, middle ear infection, and sore throat - GPs tend to prescribe antibiotics for very little or no benefit,” Dr Bakhit said.

“With acute respiratory tract infections, the benefit of using antibiotics would be a saving of around 12 hours over the duration of the whole infection.

“If a child with Acute Otitis Media takes antibiotics, their earache will on average resolve in 3 days. If a child does not take antibiotics, their earache will resolve in 3.5 days.”

Dr Bakhit said patients provided with repeat prescriptions for antibiotics tended to get the second course and keep it in their home.

“This poses an issue with antibiotic resistance and the same antibiotic is not going to be as effective the next time they use it.

“Antibiotics should not be used lightly. We need to save these treatments for when they are actually needed.”

Dr Bakhit said an option for doctors was delayed prescribing.

This was useful in the case of acute respiratory infections which can be caused by bacteria, which are susceptible to antibiotics, or a virus, which are not. It’s difficult for GPs to diagnose which is responsible for the illness.

“The patient would get his prescription with the advice not to dispense the antibiotic for a few days to wait and see how their illness goes. If it doesn't worsen, there is no need for antibiotics,” Dr Bakhit said.

“If it does get worse, then go ahead and get the antibiotic.”

Dr Bakhit said the IEBH was not advocating taking treatments away from patients, nor putting extra pressure on GPs to stop prescribing antibiotics.

“The idea is to have more a regulated process around antibiotic prescription because now we are moving towards the post-antibiotic era as described by the WHO, and it's very scary,” he said.

“If we don’t start carefully prescribing these treatments, we are facing huge community-wide problems with an increased pool of resistance strains within the community which in return increases the burden of resistant infections within hospitals.”

The IEBH is a world leader in research into evidence-based practice, including the over-prescription of antibiotics.

Bond's researchers and academic experts will come under the spotlight at next week's annual Research Week.

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