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Centre of research excellence awarded for reducing antibiotic resistance in primary care


Amanda Lyons


3/09/2018 1:53:03 PM

Reducing antibiotic prescribing can be a difficult problem for general practice, but a new $2.5 million centre of research excellence will assist by providing evidence-based research and training for GPs.

Professor Christopher Del Mar is very pleased to receive the funding for the CRE, and believes work on antibiotic resistance is very important.
Professor Christopher Del Mar is very pleased to receive the funding for the CRE, and believes work on antibiotic resistance is very important.

Professor Christopher Del Mar, GP and Professor of Public Health at Bond University, is extremely concerned about the rise of antibiotic resistance throughout the world and within Australia.
 
‘[It] is a very serious threat,’ he told newsGP. ‘It results in people not being able to be quickly cured from infections that we’ve been otherwise taking for granted.
 
‘Although, worse than that, people are actually dying from it. We estimate it’s somewhere between one and two thousand Australians every year.
 
‘And that’s set to increase. Unless we do something different, the trajectory we’re on has been modelled out to the year 2050, when [antibiotic resistance] will become the number-two killer behind cardiovascular disease. So it will overtake, for example, all cancers put together.’
 
Professor Del Mar said that while many believe antibiotic use in hospital settings is the main cause of resistance, Professor Del Mar has found general practice is also a strong contributor to the problem.
 
‘Primary care is where most antibiotics are prescribed for human use, by quite a long chalk,’ he said.
 
‘The other worry is that there just aren’t any new antibiotics coming down the pipeline, so we [GPs] must do our bit by conserving antibiotics and reducing their use as much as possible.’
 
To assist in this endeavour, Professor Del Mar and his multi-university team have been awarded a $2.5 million grant from the National Health and Medical Research Council (NHMRC) to create a centre of research excellence (CRE) focused directly on the problem.
 
‘I think it’s terribly important research that needs to be done,’ Professor Del Mar said.
 
Professor Del Mar and his team at Bond University will act as the main leads of the CRE, working collaboratively with colleagues from the universities of Queensland, Tasmania and Newcastle, as well as professional bodies including Therapeutic Guidelines and NPS MedicineWise, to provide evidence-based research, training and support to help reduce antibiotic prescribing in general practice.
 
The CRE funding will last for five years, from 2018–23, and the centre will feature five different research streams.
 
One of these streams will tackle the issue that lies at the heart of the antibiotic prescribing problem for many GPs.
 
‘The conundrum for GPs is that they want to reduce their antibiotic prescribing if they possibly can, but they don’t want to do it at the risk of safety,’ Professor Del Mar said. ‘So addressing that is quite tricky, and we need to find behavioural methods to help support GPs in that respect.’
 
The other streams will be focused on specific problem areas in terms of antibiotic prescribing, and appropriate strategies within those issues.
 
‘We focused, in [a prior CRE], on acute respiratory infections. That’s where the lowest-hanging fruit lie,’ Professor Del Mar said.
 
‘But we also want to look at urine infections and skin and soft-tissue infections. The evidence about the benefits and harms of antibiotics in those areas isn’t very well set out on the literature, and we want to investigate that quite carefully.
 
‘The next one is in residential aged care facilities. We know there is a lot of a resistance being generated there; these are sick people, and a lot of them are on antibiotics, but it’s not like the rest of mainstream general practice. There are some separate pressures and concerns in residential aged care facilities so they need quite a different phenomenological approach.
 
‘We’re also going to be looking at general practice registrars. We think it’s important they get on top of this during their training so entrenched behaviours can proceed in a much more antibiotic-conservation mind than has previously been the case.
 
‘And we’ve got some other bits and pieces we want to look at. For example, we want to assess how long it takes antibiotic resistance to decay if you don’t use antibiotics. It does happen, but it’s very poorly quantified and we want to get some information about that.’
 
The team also intends to measure the effectiveness of theirs and others’ efforts to reduce antibiotic prescribing at the end of the CRE’s five-year funding term.
 
‘We’ve designed a trial to see if we can demonstrate that we’ve been successful in reducing antibiotic prescribing, as the culmination of our work towards the end of the CRE,’ Professor Del Mar explained.
 
Professor Del Mar is very pleased to have received the funding for the CRE, and believes it shows trust in general practice to provide its own solutions to a tricky problem in primary care.
 
‘I’m delighted general practice has an opportunity to demonstrate that we don’t need to have this imposed from above in some draconian way,’ he said.
 
‘I think we’ve got the ability to look after this ourselves.’



antibiotic prescribing antibiotic resistance antibiotics antimicrobial resistance Centre for research excellence general practice research





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