Antibiotic use in the Australian community, 1990‐1995

Abstract

ObjectiveTo determine the pattern of antibiotic use in the Australian community, 1990‐1995, and compare it with the pattern in other developed countries. DesignSurvey of data from the national database on drugs dispensed in Australia (1990‐1995), an international database on retail drug sales (1985‐1994), and Australian prescriber surveys (1994,1995). Main outcome measuresNational and international retail sales of oral antibiotics (defined daily doses [DDDs]/1000 population/day) and antibiotic prescriptions dispensed through community pharmacies by drug type; antibiotic prescribing profiles for common conditions. ResultsAntibiotic use in Australia remained steady between 1990 and 1995, with an estimated 24.7 DDDs/1000 population/day dispensed through community pharmacies in 1990 and 24.8 DDDs/1000 population/day in 1995. Amoxycillin, although declining in use, remained the most dispensed antibiotic. Compared with the other countries surveyed, Australia had the highest percentage use of tetracyclines, such as doxycycline, and the lowest percentage use of fluoroquinolones. Use of trimethoprim‐sulfamethoxazole and flucloxacillin declined in Australia. In new cases of upper respiratory tract infection or pharyngitis, an antibiotic prescription was recorded for 57% of urban patient encounters and 73% of rural patient encounters. ConclusionsAntibiotic use in Australia is high, as in many other developed countries, but did not increase between 1990 and 1995. The overall profile of antibiotic use in Australia by drug class was similar to that in the United Kingdom. Antibiotics were still commonly prescribed for upper respiratory tract infection (which is usually viral), more commonly by rural than by urban general practitioners.

Knowledge, attitudes and behavior regarding antibiotics use and misuse among adults in the community of Jordan. A pilot study

“…This practice may deprive the physician of many diagnostic clues that may help to rule out viral from bacterial infections. In fact, several previous studies have reported that patient pressure was the most frequently cited reason for physicians' discomfort with prescribing antibiotics (Britten, 1995;McManus et al, 1997). Despite the accumulating evidence from clinical trials that antibiotics might modify the course of common cold symptoms (if at all), almost all physicians acknowledged that antibiotics were prescribed too often in such cases (Little et al, 1997;Mainous et al, 1996;Stott, 1979;Whitfield and Hughes, 1981).…”

“…The irrational and overuse of antibiotics result not only in the emergence of resistant bacterial strains but also in adverse reactions and economical burden on national health system (Gyssens, 2001). This irrational use arises from the economical factors, health policies concerning medical insurance, lack of physicians' concerns about long term resistance and effect versus treating current symptoms, pharmaceutical marketing and the sale of antibiotics without prescription in some countries (Metlay et al, 1998;McManus et al, 1997).…”

What can be done about resistance to antibiotics?

“…We know that it is possible to reduce antibiotic consumption in communities and countries. For instance, in the five years to 1994 per capita usage of antibiotics actually dropped in Australia, but in six other Western countries consumption has increased steadily over a decade 1. Similar sharp drops in use of penicillin in Hungary followed the discovery of high rates of resistance in pneumococci 2.…”

Disease, temporal and sociodemographic influences on initial treatment of community-acquired pneumonia in Manitoba, Canada

“…Furthermore, the proportion of subjects receiving a restricted antibiotic increased more than two-fold over the study period from 34.2% in 1996/1997 to 75.2% in 2001/ 2002. Increased consumption of newer broad-spectrum antibiotics coupled with decreased consumption of older narrow-spectrum agents has been reported worldwide [16][17][18][19]. Similarly, the increased likelihood of urban residents to receive broad-spectrum antibiotics has been previously reported [20,21].…”