Choose wisely

By Diva Madan|
2019-04-03T10:33:10+10:00
April 2nd, 2019|

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Antibiotic resistance is a grave concern for the Australian healthcare system. Antibiotics, designed to prevent infections,  have saved millions of lives since they were introduced in the 1940s. However inappropriate use of these drugs has led to antibiotic resistance.


As a result many antibiotics may no longer be effective against the bacteria they once killed.

According to Medicine Insight data 2017, the use of antibiotics has significantly increased in the past few years.

Between 1 July 2015 and 30 June 2016, the total number of antibiotic prescriptions issued were 378,979, of which 42,790 (11%) were for urinary tract infections (UTIs), mainly prescribed for asymptomatic UTI’s in older adults residing in aged care facilities.

In a recent study conducted, it was also revealed that 11.3% of residents were on antibiotics, but only 4.5% had a suspected or confirmed infection.

One in five antibiotics were written for residents who had no signs and, symptoms of infection in the week before starting the course (AURA 2016).

Only one-third of these prescriptions were appropriate. Similarly, common cold and, flu is caused by viruses and cannot be treated by antibiotics. Several clinical studies have shown that antibiotics do not improve the symptoms of a cold or the flu (Department of Health 2017).

So what can we do?

For our residents in aged care facilities, it is vital to determine the need for urinalysis and/or culture.

There is a possibility that a urinalysis may detect asymptomatic bacteriuria.

Is urine odour or cloudy urine an indication of an infection or to test urine? No.

This can be due to poor hydration, compromised personal hygiene, side effects of certain medications and poor infection control measures (Duong 2015).

A urinalysis should only be performed when there is a clinical indication. To avoid inappropriate usage of antibiotics explore other alternatives to immediate antibiotics. Infection control most importantly, effective hand hygiene is the key to prevent such infections.

Timely identification, adequate hydration, optimal personal hygiene, symptom management, awareness, and education are some of the other important ways to reduce testing and prescribing antibiotics (Centers for Disease Control and Prevention 2017).

Encouraging rest, using sore throat lozenges, a saline nasal spray for congestion are some of the ways to treat common cold symptoms.

Get a flu shot to prevent flu (NPS Medicine Wise 2017). Antibiotics aren’t always the answer. Antibiotics can only treat bacterial infections not viral infections (The Antibiotic Resistance Crisis 2015). Hence, choose wisely when it comes to tests and treatments. Use antibiotics only when needed and, if needed, use them correctly to avoid further complications such as antibiotic resistance.

References

Australian Commission on Safety and Quality in Health Care (2016) AURA, First Australian Report on Antimicrobial Use and Resistance In Human Health www.safetyandquality.gov.au Accessed March 2019.

Department of Health (2017) Antimicrobial stewardship www.amr.gov.au/what-you-can-do/aged-care/antibiotic-stewardship Accessed March 2019.

Centers for Disease Control and Prevention (2017). Antibiotic Prescribing and use in Hospitals and long-term care https://www.cdc.gov/features/getsmart/ Accessed March 2019.

Duong, A (2015). 6 Factors That Have Caused Antibiotic Resistance

http://infectioncontrol.tips/2015/11/18/6-factors-that-have-caused-antibiotic-resistance/ Accessed February 2019.

The Antibiotic Resistance Crisis (2015) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4378521/ Accessed February 2019.

NPS Medicine Wise (2017) https://www.nps.org.au/medical-info/consumer-info/antibiotics-explained?c=what-is-antibiotic-resistance-383ab578 Accessed February 2019.

Diva Madan RN, MN clinical education, BN, BSc, DN, DM, Cert IV TAE, Authorised immuniser, Nurse Educator – Higher Education,  Australian College of Nursing

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