Nov 20, 2017

Are GPs Prescribing Too Many Antibiotics?

Antibiotics are what many doctors, and therefore patients, turn to when there is a bacterial infection.

Antibiotics are used for both treatment and prevention as they kill or “inhibit” the growth of bacteria.

However, the overuse of antibiotics can also lead to resistance. This is where the bacteria are able to develop, or mutate, so that they are not impacted by the antibiotic – and then that new resistant bacteria multiply making treatment redundant.

When this happens, a new antibiotic needs to be created – but by the time it’s found, the new bacteria may have already spread and caused widespread damage.

Antibiotic resistance, essentially, makes treatable conditions “stronger”.

One recent research is suggesting that there needs to be a monitoring of antibiotic resistance rates, and has called for GP to lower the frequency that they prescribe antibiotics to the community.

According to the Medical Journal of Australia publication, an estimated 1600 people in Australia die directly from antibiotic resistance every year.

Lead author Professor Chris Del Mar, from Bond University, predicts that at this current rate, deaths from currently treatable infections will overtake total cancer deaths by 2050.

“This crisis is not directly obvious to GPs working in the community, yet GP’s contribute to most of the antibiotic tonnage consumed by humans in Australia,” says Professor Del Mar.

Antibiotics are prescribed at rates 4–9 times as high as those recommended by Therapeutic Guidelines.

Antibiotic resistance also creates problems for other treatments, such as routine surgeries.

“Without reliable antibiotic prophylaxis (treatment given to prevent disease), procedures such as chemotherapy, bone marrow transplant, much major surgery (such as joint replacement) and invasive diagnostic procedures will become too dangerous to perform,” says Professor Del Mar.

Antibiotic resistance could push many modern medical treatments back – potentially to the pre-antibiotic era of the 1930s. The research says the economic consequences of which would be catastrophic.

Pressure to Prescribe Antibiotics

The research found that there were a number of reasons why GPs were prescribing antibiotics at such high rates.

Many GPs felt pressured to prescribe a course of antibiotics because of the perception that many patients expected antibiotics more often than was realistic.

For the public, there is often a common misconception of when antibiotics need to be used.

Antibiotics do not fight infections caused by viruses like colds, flu, most sore throats, and bronchitis. Even sinus and ear infections can mostly recover without the use of antibiotics.

There is also a safety element to prescribing antibiotics, which can be used as a preventative measure. In some cases, it is difficult to separate apparently innocuous acute respiratory infections from the early stages of very serious infections.

The efficiency of the consultations and treatment also plays a role. Some GPs felt that it was quicker to finish a consultation with an antibiotic prescription, often with misconceptions about the effectiveness of antibiotics. Quicker appointments may indeed occur, but not quicker recovery time.

Antibiotics are mostly prescribed for acute respiratory infections, ‘for which they provide only minor benefits’, the report said.

“Strategies in Australia will require appropriate resources and implementation support for employing multiple modalities and a commitment for a sustained effort,” the researchers concluded.

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