Inappropriate antibiotic prescribing around the time of surgery and long-term prescribing in aged care are among a mixed bag of findings of a recent report into antibiotic use and resistance in Australia.

The report shows while fewer antibiotics are prescribed in the community than a decade ago, there is still room to improve antibiotic prescribing in hospitals.

We are both involved in antibiotic stewardship programs, primarily in hospitals, which aim to improve the use of antibiotics to improve patient care and reduce the potential for antimicrobial resistance.

Here’s why antibiotic resistance is so concerning and what the latest report tells us.

Why is antibiotic use and resistance important?

Factors driving antibiotic use tend to be different in hospitals and in the community.

In hospitals, there are more patients with infections, and these are also places where patients come to with resistant infections. Here, a common dilemma is making sure sick patients receive antibiotics quickly, balanced with not overusing them unnecessarily.

In the community, GPs often have to use careful clinical judgement to determine whether antibiotics are required, or if the patient will recover without them.

If we think of this issue at the level of individual patients, the risks may feel small. But at the population level, using the wrong antibiotic, or using it when it’s not needed, or for too long increases the risk of antibiotic resistance.

This is where bacteria become resistant to the usual treatment options, so infections may continue to progress despite treatment.

This occurs due to “selection pressure”. This means the bacteria acquire changes that enable them to evade the effect of antibiotics, and these resistant strains continue to grow and spread.

Read more: The rise and fall of antibiotics.........

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