14 May 2019

Antibiotics misuse still rife in aged care facilities

Aged Care Drugs

While rates of antibiotic use have been falling in primary care, hospital and aged care facilities are still over-prescribing and misusing these drugs, a report released earlier this month shows.

The Antimicrobial Use and Resistance in Australia (AURA) report, by the Australia­n Commission on Safety and Quality in Health Care, found that while overall antibiotic dispensing had dropped in 2016 and 2017, Australia was still in the top quarter of nations with high rates of antibiotic use.

In particular, aged care homes had high levels of both unnecessary antimicrobial prescribing and inappropriate antibiotic use.

Almost one in 10 residents of aged care homes that participated in the AURA survey was prescribed at least one antimicrobial, the authors said.

Antimicrobials were often used for unconfirmed infections in aged care homes with more than half of these prescriptions for residents who had no signs or symptoms of infection.

The report said there were high levels of infection and colonisation with multidrug-resistant organisms among aged care home residents, which supported the need for appropriate antimicrobial prescribing in these settings.

For GPs, the report said that among participating NPS MedicineWise MedicineInsight practices the rate of systemic antibiotic prescribing had steadily declined since 2010, with an absolute reduction of 5.7% from 2015.

However, antibiotics continued to be overprescribed compared with guideline recommendations.

The most commonly dispensed antibiotics were cefalexin, amoxicillin and amoxicillin–clavulanic acid.