For general practice

GPs play an essential role in national efforts to tackle antibiotic resistance. They prescribe the greatest volume of antibiotics used by Australians. By following best practice prescribing, they can reduce the amount of antibiotics used and contribute to decreasing antibiotic resistance.

Therapeutic Guidelines have published a new summary table for antibiotic prescribing in primary care (PDF, 466KB). It includes advice on alternative antibiotics to consider if first-line treatment is unavailable in a shortage situation.

What you can do

1. Consider any safe alternatives to an immediate antibiotic prescription
2. Prescribe in accordance with therapeutic guidelines, and where possible use diagnostics to inform treatment decisions
3. Talk to your patients about the importance of appropriate antibiotic use and the dangers of antibiotic resistance
4. Give your patients advice on how to manage symptoms without antibiotics
5. Apply best practice infection prevention and control
6. Talk to your patients about how to prevent infections and their spread (e.g. vaccination, good hygiene and hand washing)

Key issues

• The main cause of antibiotic resistance is antibiotic use. The more we use antibiotics, the more chance resistance will develop and spread.
• In Australia, we use more antibiotics in the community than in hospitals.
• In 2015:
  • 44.7% of the Australian population (about 10.7 million people) received a prescription for at least one antibiotic.
  • more than 30 million antibiotic prescriptions were dispensed under the Pharmaceutical Benefits Scheme (PBS) and Repatriation PBS.
• Australia is the eighth highest user of antibiotics out of 28 European countries, and is more than double that of several north European countries.
• Prescribing antibiotics when they are not needed increases the risk of resistance without any benefit to the patient.   
• In the Australian community, antibiotics are prescribed for acute respiratory tract infections four to nine times more than guidelines recommend.
• In 2015, data collected through the MedicineInsight program showed that 60% of patients with acute respiratory infections were prescribed antibiotics. Infections included:
  • acute sore throat
  • acute sinusitis
  • acute otitis media
  • acute bronchitis.
• In most cases guidelines do not recommend prescribing antibiotics for these conditions
• Most methicillin-resistant Staphylococcus aureus (MRSA) blood stream infections are now acquired in the community.

Areas for action

• Reduce the use of antibiotics that are not consistent with the prescribing guidelines—especially for acute respiratory infections.
• Educate patients in
  • cough and hand hygiene
  • the impact of antibiotic resistance 
  • the lack of benefit from antibiotics for most acute respiratory infections.
• Nurses also play an important role in combating antimicrobial resistance. You can find more information on the Nurses and Antimicrobial Resistance fact sheet.