Antibiotic resistance and antibiotic use in human health in Australia
Bacteria that are resistant to antibiotics are a concern for health care in Australia.
To help reduce antibiotic resistance, we are closely watching two important areas:
- Antibiotic use and appropriate prescribing: if we reduce antibiotic use we can reduce the chance that resistance will develop.
- Antibiotic resistance: if we understand the patterns of antibiotic resistance in Australia we can make changes to reduce the spread and growth of resistant bacteria.
Antibiotic use in Australia
- Australians are over-using antibiotics.
- Australia is the eighth highest user of antibiotics out of 28 European countries.
- In 2015, Australian doctors prescribed more than 30 million antibiotic scripts through the Pharmaceutical Benefits Scheme.
- Doctors are prescribing antibiotics to prevent infection during surgery for longer periods than they should.
- In hospitals, antibiotic use decreased by 9.2% between 2010 and 2015 after stewardship practices came into effect.
Antibiotic resistance in Australia
Antibiotic resistance is happening now in Australia and around the world. Some bacteria that can cause serious illness are becoming resistant to common antibiotics.
Which bugs are of most concern in Australia?
In hospitals, bacteria resistant to some important antibiotics caused a number of infection outbreaks in 2015. Two important examples are:
- Carbapenemase-producing Enterobacteriaceae, or ‘CPE’ – a bacteria that can cause urinary tract infections, pneumonia, bladder or kidney infections and bloodstream infections.
- Vancomycin-resistant enterococci, or ‘VRE’ – the cause of wound, urinary tract and bloodstream infections. The rate of VRE in Australia is now higher than any European country.
In the community, two important examples are:
- A strain of methicillin-resistant Staphylococcus aureus, golden staph, or ‘MRSA’ – a potentially dangerous bacteria that may cause skin and other infections. These infections are now more common in the community than in hospital.
- The bacteria that cause gonorrhoea (a sexually transmitted disease) are becoming more resistant to the common antibiotics used for treatment.
The Australian report on antimicrobial use and resistance in human health (AURA 2021) has further details about antibiotic use and resistance in human health in Australia. A 2023 update will be available later in 2023.
The good news
We are taking action in Australia to reduce antibiotic resistance by:
- raising awareness about antibiotic resistance and the importance of using antibiotics only when they are needed
- supporting health professionals to prescribe antibiotics only in situations where they are needed
- informing the general public about the proper way to use antibiotics
- continuing to monitor antibiotic use and resistance in Australia
- promoting good infection prevention and control practices to limit the development and spread of antibiotic resistance
- supporting research and development so we can find better ways to deal with AMR.
How Australia compares to other countries
Australia compares its rates of antibiotic resistance with European countries. This is because Australian and European surveillance systems are similar.
In 2015, Australia had the eighth highest antibiotic usage rate compared with 28 European countries. Australia’s usage rate is much higher than the countries with the lowest use, such as The Netherlands, Sweden and Austria.
In hospitals in 2015:
- the Netherlands usage rate, per 1000 people, was less than a third of Australia’s
- Scotland was the only country with a higher rate of antibiotic use than Australia.
Compared to European countries, Australia has:
- Low rates of resistance to the following antibiotics:
- Fluoroquinolone – because use of this antibiotic is restricted in Australia in both community healthcare and hospitals.
- Broad spectrum cephalosporin – which has a variety of uses to treat and prevent infections.
- Medium rates of resistance to the antibiotic methicillin in Staphylococcus aureus bacteria, also known as MRSA or ‘golden staph’.
- The highest rate of vancomycin-resistant enterococci, or ‘VRE’. Controlling the spread of VRE organisms in hospitals is an increasing problem in Australia.