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Most Australians oblivious to ‘superbug’ threat


Matt Woodley


20/05/2020 4:19:05 PM

New research reveals widespread ignorance to the dangers of antimicrobial resistance, which claimed an estimated 700,000 lives globally last year.

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More than nine in 10 Australians don’t know the difference between a bacterial and viral infection.

The ‘concerning’ findings show 92% of Australians quizzed were unable to differentiate between a viral and bacterial infection, driving fears the world will return to the ‘medical dark ages’ if antibiotic overuse is not curbed.
 
The CSIRO-commissioned survey also found:

  • 13% of Australians wrongly believe coronavirus can be treated with antibiotics
  • 19% thought antibiotics were needed to treat the common cold
  • 14% have taken antibiotics prophylactically (‘just in case’) when travelling overseas.
RACGP Queensland Chair Dr Bruce Willett, who has previously sounded multiple warnings on the threat of superbugs, told newsGP he is surprised by the results.
 
‘All GPs know there is widespread misunderstanding about the use of antibiotics, but the figures are even worse than expected,’ he said.
 
‘The fact that 92% of Australians don’t know the difference between a bacterial and viral infection is horrifying; it means that we have no basis on which to begin a discussion on appropriate use of antibiotics.’
 
To combat the growing problem – which if left unchecked could lead to 10 million deaths per year by 2050 – a consortium of university, government and industry partners has established the OUTBREAK project, which will aim to use artificial intelligence to predict superbug outbreaks and stop them before they reach the health system. The team is also aiming to share trusted information on antibiotic resistance and build community knowledge in Australia.
 
CSIRO Biosecurity Research Director Dr Paul De Barro, who is part of the OUTBREAK Executive team, said the new project is a ‘unique opportunity’ to be proactive against superbugs, but added that the results of the recent survey are concerning.
 
‘The misuse and overuse of antibiotics is a huge problem,’ he said. ‘When we run out of effective antibiotics, we’ll be back in the medical dark ages of the pre-1940s, where a scratch or simple infection killed, so it’s critical that the public are educated on this issue.’
 
Mandatory-reporting-Bruce-Willett-Hero.jpg
‘The fact that 92% of Australians don’t know the difference between a bacterial and viral infection is horrifying; it means that we have no basis on which to begin a discussion on appropriate use of antibiotics,’ Dr Bruce Willett said.

With some estimates also indicating that antimicrobial resistance could cost the global economy US$100 trillion by 2050, including a 5–10% reduction in Australia’s GDP, Dr Willett said concerted efforts to educate patients must continue.
 
‘I have been a GP for many decades now and my sense is the education of patients around this topic has improved considerably, which makes these figures all the more shocking,’ he said. 
 
‘Last year I was reviewing the UK threat register. Interestingly, a world pandemic was number one but antibiotic resistance was not far behind.
 
‘Widespread antibiotic resistance will essentially play out very much like a pandemic, but slower.
 
‘As GPs we clearly need to be doing better, but we also require more support from government and the media in getting this message across.’

To implement OUTBREAK – which will analyse data from areas including agriculture, wastewater and hospitals to predict drug-resistant infections in real time and model the best way to manage outbreaks before they reach the healthcare system – the project team is seeking a five-year, $100 million investment from the Federal Government’s Medical Research Future Fund.
 
University of Technology Sydney Associate Professor and OUTBREAK CEO Branwen Morgan said this ‘One Health’ approach is designed to cover significant gaps in previous research that has focused solely on antimicrobial resistance in human health.
 
‘As well as people, we will look at how animals, plants and the environment contribute to antimicrobial resistance,’ Associate Professor Morgan said.
 
‘Drug-resistant bacteria can infect anyone regardless of age, gender or location. To fight them, we need to fully understand which ones are a threat to our health and how they are spreading into and within Australia.
 
‘This will help us to intervene in ways that will have the greatest positive impact on our health and economy.’

Full CSIRO survey
 
Do you know the difference between a virus and bacteria? 
  • Yes – 8.5%
  • Unsure – 63.8%
  • No – 27.7% 
Which conditions can be treated with antibiotics (choose any that apply)? 
  • Ear infection – 67% said yes
  • Urinary tract infection – 67% said yes
  • Pneumonia – 47% said yes
  • Skin infection – 47% said yes
  • Bronchitis – 45% said yes
  • Sore throat – 42% said yes
  • Flu – 34% said yes
  • Common cold – 19% said yes
  • Chicken pox – 15% said yes
  • Diarrhoea – 15% said yes
  • Coronavirus – 13% said yes 
Have you ever taken antibiotics ‘just in case’ when travelling overseas? 
  • Yes – 14% (aged 25–34 are most likely; men 17%, women 12%)
  • No – 80%
  • Unsure – 6%
Have you ever taken antibiotics which didn’t clear up your infection? 
  • Yes – 40%
  • No – 49%
  • Unsure – 11% 
Have you ever asked your doctor to prescribe antibiotics for an illness? 
  • Yes – 32%
  • No – 61%
  • Unsure – 7% 
How do you feel about taking antibiotics if they are prescribed by your doctor (choose one)? 
  • I am happy to take them for as long as needed – 56.8%
  • I am content to take one course but then I seek other treatments or advice – 16.7%
  • I am reluctant to take them but I do if they are recommended – 23%
  • I don’t take antibiotics – 3.5%
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Dr Cho Oo Maung   21/05/2020 10:48:20 AM

If we go to third would, antibiotics are over the counter. If we go to GP for RTI , the doctors are jabbing with Penicillin. If we can't cure in day one , the patient will see another doctor next day and they may miss the whole course of antibiotic. However, the death due to COVID was much lesser in third world, even crowded and malnutrition. Billions of people in third world are abusing antibiotic for several decades. Australia is let say only 25 millions.

There is a philosophy of secondary bacterial infection or underlying Malaria relapse when we get cold causing declined defense due to virus. Before COVID era, the patient looks well with CXR showed pneumonia, we treated this RTI as Atypical Pneumonia by Doxycycline. So, I rather take Amoxycillin, added with Doxy than Hydroxychloroquine , if I get really sick by COVID. Reluctant to use right antibiotics in right person could increase morbidity and mortality of COVID. Treatment error could also be confounder for COVID deaths.


Dr Annette Hackett   21/05/2020 1:14:45 PM

We only have ourselves to blame. Who writes the script? Who can have the conversation? Who can teach? Yes, there are other sources of antibiotic resistance (other than GP prescriptions), but we have the greatest contact with the population, and ever so many chances to educate. We just have to do it.


Dr Natalie Alexandra Cook   21/05/2020 7:14:56 PM

when pt ask is it bacterial or viral URTI/LRTI? what is the answer? ok, i need to stay at home if it is viral URTI/LRTI for 1-2 weeks and if not getting better come to see you for ab script .. but I have only 5 days sick leave not 3-4 weeks, what about transmission of common Legionella, Mycoplasma, Chlamydia, Strep, H. inf and other bacteria in community if it is bacterial, will spread of respiratory infection bacterial ethiology increase ab resistance in the community?