Australian-first study warns of escalating antibiotic prescriptions

The latest research from the SAHMRI-based Registry of Senior Australians (ROSA) points to a sustained escalation in antibiotic prescribing for older people living in residential aged care facilities (RACFs). 

Lead author Dr Janet Sluggett says national study was a first for Australia. 

“Antibiotic use is particularly prevalent among older people but when it comes to RACFs we simply didn’t have any national data about changes in antibiotic use until this study,” she said. 

The pharmacist and Senior Research Fellow with the University of South Australia says unless antibiotic use is closely monitored it could compound the infection risk from increasing rates of multidrug-resistant organisms. 

“Overexposure to antibiotics can cause the bacteria we’re trying to eliminate to become resistant to our treatments,” Dr Sluggett said. 

“Across the health system, we need to be really discerning about antibiotic use as much as possible to guard against antibiotic resistance, as well as unnecessary side-effects for individuals.” 

The project examined antibiotic dispensing among more than half a million people aged 65 or over from more than 3200 RACFs across Australia over a 10-year period. More than 5.6 million antibiotic prescriptions dispensed to residents between July 2005 and June 2016 were analysed. 

“This nationwide study showed substantial increases in both the percentage of people who received an antibiotic and the total number of antibiotic doses supplied,” Dr Sluggett said. 

“In the first year of the study, almost 64 per cent of residents received an antibiotic at least once. By the final year that figure climbed to more than 70 per cent, at an annual rate of increase of 0.8 per cent.” 

Residents were often dispensed antibiotics multiple times each year - a median of three times annually. 

Researchers also found the number of standard daily doses dispensed per 1000 resident-days jumped from 67.6 to 93.8 - a relative increase of 39 per cent in overall consumption. 

“Older age, multiple health conditions and frequent contact with other residents and staff can place people living in RACFs at risk of infection,” Dr Sluggett said. 

“Sometimes antibiotics are needed of course but our findings point to a need for greater efforts to support antibiotics to be used in the best possible way in this population. 

“We can all play a role in making sure antibiotics are only used when necessary. If you, or a family member living in an RACF, are taking an antibiotic and you aren’t sure if it is still needed, asking the GP or the nursing staff at the RACF is a good first step.” 

The findings of this work were published in the journal Clinical Infectious Diseases. 

They can be used to inform governance of antibiotic use in accordance with updated national Aged Care Quality Standards.