Relationship between antimicrobial-resistance programs and antibiotic dispensing for upper respiratory tract infection: An analysis of Australian data between 2004 and 2015

Wu, Jianyun; Taylor, Daniel J.; Ovchinikova, Ludmila; Heaney, Aine; Morgan, Tessa; Dartnell, Jonathan; Holbrook, Rachel; Humphreys, Lauren; Weekes, Lynn; Blogg, Suzanne

doi:10.1177/0300060517740813

Cited by 27 publications

(17 citation statements)

References 17 publications

(25 reference statements)

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“…[6] Several studies have reported the relationship between the uncontrolled use of antibiotics and increased resistance to them. [7] Countries having the highest rate of antibiotic use have reported highest antibiotic resistance. [8] While health-care physicians are aware of the fact that most of the URTIs have viral origin, [9] prescription of antibiotic for URTIs has become a common practice in pediatric clinics.…”

Section: Research Articlementioning

confidence: 99%

Untitled

Sadeghi¹

2018

AJP

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Background and Objective: As majority of upper respiratory tract infections (URTIs) have a viral origin, antibiotic prescription for URTIs has become a common practice in pediatric medicine. The prescription of an inappropriate and unnecessary antibiotic is the main cause of the development and increase of antibiotic resistance. The factors involved in high level of using antibiotics include knowledge and attitude on the use of antibiotics, patient satisfaction with treatment, and the relationship between physician and patient, and patient experience in the use of antibiotics. Thus, the objective of this research was to evaluate the knowledge, attitude, and practice (KAP) of parents with regard to the use of antibiotics for URTIs in children admitted to Infectious Diseases Clinic of Shahid Motahari Hospital in Urmia in 2017-2018. Methodology: The current research is an analytical crosssectional study. The research population included parents who have children aged 1-8 years and admitted to the infectious diseases clinic of the Motahari Hospital in Urmia from all parts of the province. In this research, KAP of patients was evaluated with regard to the use of antibiotics for acute URTIs in children based on age, education level, and living place. SPSS software version 21 was used to analyze the data. Results: Of 400 parents examined, 58.8% were female and 41.2% were male. In addition, 75% of the parents were living in cities, 23.3% of them had academic level of education, and 12% were illiterate. A significant relationship was found between the level of education, the living place, and the KAP of parents with regard to the use of antibiotics for URTIs. There was also a significant relationship between age and attitude and practice of parents, but age was not significantly correlated with parent knowledge. Parents admitted to the hospital stated that the most reason for the arbitrarily use of antibiotics was its prescription by physician in the same condition. During 3 months before admitting to the hospital, 54.2% of the parents used the antibiotic arbitrarily for URTIs children. Conclusion: Low level of knowledge and attitude of parents about URTIs and high levels of arbitrarily use of antibiotic in this study make it necessary to provide educational programs for parents with regard to infections common among the children and, their treatment more supervision over pharmacies and retraining courses for physicians.

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Section: Research Articlementioning

confidence: 99%

Untitled

Sadeghi¹

2018

AJP

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“…Interventions designed to improve antimicrobial prescribing have shown success amongst GP trainees and supervisors [18][19][20][21][22]. Additionally, international interventions focussing on factors influencing inappropriate prescribing have been shown to improve antibiotic prescribing over time [15,[23][24][25][26], particularly for respiratory tract infections [27][28][29][30]. These interventions include educational sessions [31,32] and support material for GPs [33,34].…”

Section: Introductionmentioning

confidence: 99%

The effectiveness of a simple antimicrobial stewardship intervention in general practice in Australia: a pilot study

et al. 2020

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Background: Inappropriate and excessive antimicrobial prescribing can lead to antimicrobial resistance. Antimicrobial Stewardship (AMS) principles are not well established in general practice in Australia despite the relatively high rate of community antimicrobial prescribing. Few interventions have been implemented that have resulted in a significant reduction or improvement in antimicrobial prescribing by General Practitioners (GPs). This study was therefore conducted to assess the impact of a novel GP educational intervention on the appropriateness of antimicrobial prescriptions as well as GP compliance with antimicrobial prescription guidelines. Methods: In 2018, a simple GP educational intervention was rolled out in a large clinic with the aim of improving antimicrobial prescribing. It included face-to-face education sessions with GPs on AMS principles, antimicrobial resistance, current prescribing guidelines and microbiological testing. An antibiotic appropriateness audit on prescribing practice before and after the educational intervention was conducted. Data were summarised using percentages and compared across time points using Chi-squared tests and Poisson regression (results reported as risk ratios (RR) with 95% confidence intervals (CI)).

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“…It is estimated that each year infections caused by antibiotic-resistant pathogens result in 700,000 deaths worldwide; the number might reach 10 million in 2050 if there is no effective action to curb resistance [1]. The overuse of antibiotics is considered as an important contributor to antibiotic resistance, [2] which could be effectively reduced by appropriate antibiotic stewardship [3]. To guide the use of antibiotics, the World Health Organization (WHO) proposed a three-category antibiotic classification system in 2017 [4]: namely access, watch, and reserve group antibiotics.…”

Section: Introductionmentioning

confidence: 99%

Microbiology testing associated with antibiotic dispensing in older community-dwelling adults

et al. 2020

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Background: It is commonly recommended that microbiological assessment should accompany the use of antibiotics prone to resistance. We sought to estimate the rate of microbiology testing and compare this to dispensing of the World Health Organization classified "watch" group antibiotics in primary care. Methods: Data from a cohort of older adults (mean age 69 years) were linked to Australian national health insurance (Pharmaceutical Benefits Scheme & Medicare Benefits Schedule) records of community-based antibiotic dispensing and microbiology testing in 2015. Participant characteristics associated with greater watch group antibiotic dispensing and microbiology testing were estimated using adjusted incidence rate ratios (aIRR) and 95% confidence intervals (CI) in multivariable zero-inflated negative binomial regression models. Results: In 2015, among 244,299 participants, there were 63,306 watch group antibiotic prescriptions dispensed and 149,182 microbiology tests conducted; the incidence rate was 0.26 per person-year for watch group antibiotic dispensing and 0.62 for microbiology testing. Of those antibiotic prescriptions, only 19% were accompanied by microbiology testing within − 14 to + 7 days. After adjusting for socio-demographic factors and co-morbidities, individuals with chronic respiratory diseases were more likely to receive watch group antibiotics than those without, e.g. asthma (aIRR:1.59, 95%CI:1.52-1.66) and chronic obstructive pulmonary disease (COPD) (aIRR:2.71, 95%CI:2.48-2.95). However, the rate of microbiology testing was not comparably higher among them (with asthma aIRR:1.03, 95%CI:1.00-1.05; with COPD aIRR:1.00, 95%CI:0.94-1.06). Conclusions: Priority antibiotics with high resistance risk are commonly dispensed among community-dwelling older adults. The discord between the rate of microbiology testing and antibiotic dispensing in adults with chronic respiratory diseases suggests the potential for excessive empirical prescribing.

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Relationship between antimicrobial-resistance programs and antibiotic dispensing for upper respiratory tract infection: An analysis of Australian data between 2004 and 2015

Cited by 27 publications

References 17 publications

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Untitled

The effectiveness of a simple antimicrobial stewardship intervention in general practice in Australia: a pilot study

Microbiology testing associated with antibiotic dispensing in older community-dwelling adults

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