Sep 02, 2024

A simple treatment for ‘superbugs’ may not be so simple

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South Australian researchers have investigated ‘superbugs’ and suggested that overprescribing of antibiotics could put vulnerable older Australians at risk of later infection.

In the recently published study, researchers gave older Australians living in residential aged care facilities doxycycline, a broad-spectrum antibiotic drug, and monitored how this impacted gut resistance.

Antibiotics are a form of antimicrobial medication that is used to treat infections. Other examples of antimicrobials include antiviral and antifungal treatments.

When someone has a bacterial infection, using an antibiotic can kill the bacteria or stop it from multiplying.

However, excessive use of antimicrobial treatments in humans, animals and plants can lead to antimicrobial resistance. 

This occurs when ‘bacteria, viruses, fungi and parasites no longer respond to antimicrobial medicines,’ according to the World Health Organization

For example, some bacteria have evolved enough so they don’t die when exposed to antibiotic treatment. Such resistance to treatment means that unaffected infections and associated bacteria are dubbed ‘superbugs.’

Lead author of the study and PhD student at Flinders University, Sophie Miller, highlighted why prescribing antibiotics in long-term aged care should be carefully decided.

“Commonly used tablet antibiotics in the elderly increase many types of resistance bacteria carried in the gut and these so-called ‘superbugs’ can increase resistance to other important life-saving antibiotic drugs,” she said.

“High rates of antibiotic prescriptions in aged care settings are likely to be contributing to the proliferation of these bugs, which can lead to longer hospital stays, higher medical costs and increased mortality.”

The Australian Medical Association highlighted studies where Australian hospitals ‘spend an additional $16.8 million dollars per year treating common resistant hospital-associated infections.’

Ms Miller continued to explain that it’s not only treating a current infectious disease that must be considered when prescribing antibiotics. 

“We discovered that an antibiotic commonly prescribed to aged care residents was strongly associated with an increase in resistance to other antibiotics the resident had not been prescribed,” she said.

“Our findings suggest that even antibiotics that are not typically associated with major modifications in gut bacteria can significantly escalate the presence of resistance genes.” 

Around 456,000 Australians live in residential care or use aged care services, including 193,000 Australians who live in permanent or respite residential care, according to recent data from the Australian Institute of Health and Welfare.

Professor Geraint Rogers, director of the Microbiome and Host Health Program at the South Australian Health and Medical Research Institute, understood that as Australia’s population continues to age, more focus must be placed on antibiotic management.

“As the population ages and life expectancy extends, the implications of our findings emphasise the importance of a holistic approach to antibiotic management in long-term aged care settings,” he said.

“There are concerns that practitioners may be overprescribing antibiotics, potentially increasing the risk of resistant bacterial infections and this study’s findings suggest a need for extra caution when prescribing them for older patients.” 

Although Australian researchers have found a connection between resistant bacterial infections and the possible overuse of antibiotics, identifying better management of antibiotic use in aged care homes could be the next step in reducing this growing concern. 

The Australian Government recently announced that eligible aged-care homes can access on-site pharmacists through their local community pharmacy. 

The optional program means that residents in aged care facilities will find it easier to access pharmacists’ advice and this is expected to increase coordination with other health professionals including general practitioners and nurses. 

As part of their role, these on-site pharmacists will ‘regularly review medications to reduce medication-related harm and optimise the use of medicines.’

To read more about the program, eligibility requirements and how to contact your local community pharmacy, visit the Department of Health and Aged Care website.

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