Only about one in four rounds of antibiotic use in Australia’s aged care homes was deemed appropriate, in a global study.
The Macquarie University research, published in the leading academic journal PLoS One, said almost seven out of 10 people living in aged care received antibiotics in the previous 12-month period in Australia.
This compared to 54 per cent in the United Kingdom, and 63 per cent in the Netherlands and North America.
Senior Research Fellow with the Australian Institute of Health Innovation at Macquarie University, Dr Magda Raban, said there were clear guidelines for antibiotic use but the data suggested the medications were dispensed too often.
“Australia generally has high antibiotic use compared to other countries,” she said. “We know nationally as a whole antibiotic use is high and it has been for a long time.
“Until very recently we haven’t had any targeted response to antibiotic use in residential aged care. This research really highlights this need. It’s quite a specific population.”
She said antibiotic-use criteria were set for different conditions and scenarios, and “inappropriate” use ranged from prevention or asymptomatic infections. The study found only 28 per cent of uses were appropriate.
“Once the decision has been made to use an antibiotic, it’s a matter of using the right one,” she said.
There is global concern about the rise of resistance worldwide, which is creating treatment challenges.
Dr Raban has called for changes to the oversight of prescription drugs in aged care, as part of a push to improve medication management and administration.
She said linking health and IT systems, and dispensing databases would allow better management.
“We are looking at how digital systems that are making inroads into aged care now, can be leveraged to address some of these issues,” she said.
“They can also allow decision support at various points in the decision-making system, as well as the data. The providers really need to understand what the patterns are before they can address them.”
The research comes as the Australian Aged Care Quality and Safety Commission also published material reinforcing the problem of antibiotic overuse.
It highlights the looming problem of resistant bacteria, when antibiotics cease to be effective, which can spread through aged care facilities.
They also focus on the side effects of using the antimicrobials. These include loss of appetite and thirst, diarrhoea, thrush, rashes and nausea, all of which can be worse in older people. It also warns of allergies or drug interactions.
“Antibiotics are precious and powerful drugs – and they should only be used for specific purposes,” it said.
“When antibiotics are needed, their benefits outweigh the risks of side effects and antibiotic resistance.
“But antibiotics are not always needed. When they aren’t needed, they won’t help you, and the side effects could still cause harm and contribute to antibiotic resistance.”
The publication reminds people to ask what the drug is and what it is for, whether the condition would improve without it, whether any tests would assist a diagnosis, or if there are other treatments available.
Basic hand hygiene and covering coughs is also important.
