Antibiotic prescribing in Australian general practice: How has it changed from 1990–91 to 2002–03?

Abstract

There is increasing evidence that antibiotics have limited value for many respiratory illnesses. This study investigates changes in overall antibiotic prescribing rates, and rates for specific conditions, by Australian general practitioners (GPs) between 1990-91 and 2002-03. This is a comparative study of two cross-sectional surveys of general practice activity, the Australian Morbidity and Treatment Survey (AMTS) 1990-91 and Bettering Evaluation and Care of Health (BEACH) 2002-03. Both studies used random samples of GPs, each providing data about a cluster of patient encounters. Outcome measures are the antibiotic prescribing rate per 100 encounters or per 100 selected problems managed. Between 1990-91 and 2002-03, the overall antibiotic prescribing rate decreased 24.3% from 18.9 prescriptions per 100 encounters to 14.3 (P<0.001). For children, the decrease for acute upper respiratory tract infection (URTI) was from 39.0 per 100 URTI problems to 24.4 (P<0.001), while the antibiotic prescribing rate increased for acute otitis media, decreased for bronchitis/bronchiolitis, and remained unchanged for other respiratory problems analysed. For adults the antibiotic prescribing rate for URTI decreased from 58.2 per 100 URTI problems to 40.0 (P<0.001), increased significantly for sinusitis and remained unchanged for all other respiratory problems. Antibiotic prescribing decreased significantly between 1990-91 and 2002-03 but the decrease was selective. The decline has been more pronounced among children than adults, and particularly for URTI. While the message of educators may be achieving its goal for URTI, other approaches targeting specific respiratory problems may be required to reduce antibiotic prescribing in these areas.

Validating the Children’s Medicines Use Questionnaire (CMUQ) in Australia

“…The most common illnesses for which children were treated by GPs in this study were asthma, upper respiratory tract infections (URTIs), allergies and conjunctivitis, similar to previous reports [1]. Despite evidence of the limited effects of antibiotics in conditions such as URTIs, sinusitis and otitis media [32], these appeared to be commonly used and interestingly, the majority of harm reported in the survey was due to antibiotic adverse effects. This highlights that further investigations of these issues in populations studies is imperative to improve how medicines are used safely and effectively in children.…”

New horizons: otitis media research in Australia

“…Although children under 2 years of age with bilateral AOM or otorrhoea are most likely to benefit from antibiotic treatment, subgroups of children most likely to benefit from surgery for chronic OME have not yet been identified 19 , 20 . Despite the ready availability of high‐quality evidence, studies suggest that there has been no reduction in active treatment strategies used by Australian doctors 21 , 22 …”

Consumer knowledge and perceptions about antibiotics and upper respiratory tract infections in a community pharmacy

“…Treatment guidelines recommend avoiding the use of antibiotics in most respiratory tract infections to limit adverse drug reactions and bacterial resistance [10]. Antibiotic overuse and misuse in Australia has been offset by various consumer educational campaigns which began in 2000 [11] and there was a decline in the frequency of antibiotic prescriptions dispensed in community pharmacies between 1998 and 2002; however, the decline was greater among children than adults [12]. The campaigns were run by the Australian National Prescribing Service (NPS) Medicinewise and have received international attention; topics include the ''Common Colds Need Common Sense, They Don't Need Antibiotics'' campaign (2004) which was disseminated via TV, print and radio, and the ''Resistance Fighter'' campaign in 2012 which used social media sites such as Facebook [2,13].…”