Antibiotic resistant infections are one of the biggest challenges for hospitals to deliver safe and effective healthcare. Patients with antibiotic-resistant infections are more likely to experience:
- ineffective treatment
- treatment toxicity
- recurrent infection
- delayed recovery
A key driver of antibiotic resistance is the inappropriate use, or overuse, of antibiotics.
Antibiotic resistant infections are usually spread by direct contact of the infected patient with staff and other patients. They can also spread through contaminated surfaces. To help prevent the spread of infections, make sure you adhere strictly to infection prevention and control guidelines, including practising good hygiene and hand washing.
Antimicrobial stewardship is a key strategy in local and national programs to prevent the emergence of antibiotic resistance. It is also an important part of decreasing the number of infections that can be prevented in healthcare settings.
What you can do
- Consider any safe alternatives to an immediate antibiotic prescription
- Prescribe in accordance with therapeutic guidelines, and where possible use diagnostics to inform treatment decisions
- Talk to your patients about the importance of appropriate antibiotic use and the dangers of antibiotic resistance
- Give your patients advice on how to manage symptoms without antibiotics
- Apply best practice infection prevention and control
- Talk to your patients about how to prevent infections and their spread (e.g. vaccination, good hygiene and hand washing)
The Australian report on antimicrobial use and resistance in human health (AURA 2017) collates data on antimicrobial use and resistance in Australian hospitals. The report found that:
- In 2015, 23.3% of antibiotic prescribing in hospitals did not comply with guidelines and 21.9% were assessed as inappropriate, as:
- an antimicrobial was not needed
- the spectrum of the antibiotic selected was too broad for what was needed
- the length of treatment or dose was incorrect.
- 27.4% of surgical prophylaxis prescriptions were continued for longer than 24 hours. This is well above what is recommended.
- There has been an increase in rates of fluoroquinolone resistance in Escherichia coli from blood cultures (+2.5%) and Shigella sonnei (+10.9%).
- Vancomycin-resistant enterococci (VRE) is a major healthcare problem in Australia.
- Australia has average rates of resistance to methicillin in Staphylococcus aureus when compare with European countries. We also havethe highest rate of resistance to vancomycin in Enterococcus faecium.
Areas for action
- Use the best ways to prevent and control infections to limit the spread of infections, including antimicrobial resistant infections.
- Improve the use of antibiotics by adhering timing and duration of treatment set out in the Therapeutic Guidelines: Antibiotic.
- Start an antimicrobial stewardship program in your healthcare setting with key performance indicators. The Antimicrobial Stewardship Initiative has information on how to set-up an antimicrobial stewardship program.
- Nurses also play an important role in combating antimicrobial resistance. You can find more information on the Nurses and Antimicrobial Resistance fact sheet.