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Hopes for ‘sustained improvement’ in appropriate prescribing


Jolyon Attwooll


19/10/2023 4:48:41 PM

A report shows a significant rise in the number of antimicrobial prescriptions in 2022 – but the rate remains below pre-pandemic levels.

Medication in blister pack.
While Australian antimicrobial use rose in 2022, it remains much less than it was a few years ago.

A new analysis released by the Australian Commission on Safety and Quality in Health Care (ACSQHC) has found ‘sustained reductions in antimicrobial use’ in 2022, despite a year-on-year increase.
 
The ACSQHC technical report shows a 9.6% rise in the number of antimicrobial prescriptions in 2022 compared to the previous year, but notes the levels supplied remain ‘well below’ pre-pandemic levels.
 
The data tracks back seven years to 2015, illustrating a steep decline in antimicrobial use after 2019.
 
There were 21,848,005 antimicrobial prescriptions under the PBS and the Repatriation Pharmaceutical Benefits Scheme (RPBS) in 2022, the report states, with cefalexin, amoxicillin and amoxicillin–clavulanic acid the most prescribed.
 
That compares to 26,669,561 in 2019.
 
Authors cites two significant factors in the changing level of prescriptions. Firstly, in April 2020, the policy for repeat prescribing of certain common antibiotics was changed, with a reduced number of repeat prescriptions for amoxicillin, amoxicillin–clavulanic acid, cefalexin, doxycycline and roxithromycin.
 
They also highlight the influence of infection controls introduced in early 2020.
 
‘The ongoing impact of reducing the number of repeats supplied and improved infection prevention and control as a result of the COVID-19 pandemic appears to have led to sustained reductions in antimicrobial use in 2022,’ they wrote.
 
Local area data is included, with the highest age-standardised rate of all antimicrobial prescriptions per 1000 people registered in Richmond – Windsor in NSW (1512) in 2022 and the lowest in East Arnhem in NT (34).
 
Melbourne City had the greatest year-on-year increase in 2022 at 29.2%, with seven of the other 10 fastest rising areas for prescription levels also in the Victorian capital.
 
The overall age-standardised rate of antimicrobial prescriptions per 1000 people was 817 in 2022, against 744 in 2021, with that figure reaching as high as 1228 in 2015.
 
The report notes recent antimicrobial shortages driven by increased global demand, as well as production shortfalls.
 
‘The shortages are expected to extend across 2023, with associated influences on antibiotic use,’ authors wrote.
 
They state that antimicrobial consumption has increased by almost 50% around the world in the past 20 years ‘mostly driven by a rise in use in low- and middle-income countries’.
 
However, they say antimicrobial use remains higher in high-income countries.
 
The technical report was published ahead of the release of the ACSQHC’s ‘AURA’ study on 16 November, which will be the commission’s fifth report on antimicrobial use and resistance. It will outline trends across acute and community care settings.
 
The World Health Organization has described antibiotic resistance as ‘one of the biggest threats to global health, food security, and development’.
 
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ACSQHC antimicrobial prescriptions Australian Commission on Safety and Quality in Health Care


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