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 2021) collates data on antimicrobial use and resistance in the Australian healthcare system, including from public and private hospitals. The AURA 2021 report found that:
- Antimicrobial use has been gradually increasing since 2017 in Australian hospitals participating in surveillance.
- Many of the most commonly used antimicrobials in hospitals also have the highest rates of inappropriate prescribing; particularly cefalexin and amoxicillin–clavulanic acid.
- The overall appropriateness of prescribing across all hospital peer groups participating in surveillance was 75.8% in 2019. This has essentially remained static since 2013. However, both participation rates and appropriateness varied depending on the type of hospital, with improvements in some and deterioration in others.
- For surgical prophylaxis, antimicrobial prescribing was appropriate in 56.7% of all surgical episodes audited in 2019. 30% of surgical prophylaxis was given for longer than 24 hours in 2019, compared with 41.0% in 2013. This period of prophylaxis is well above what is recommended.
- Although Australia’s rates of fluoroquinolone resistance in Escherichia coli and Klebsiella pneumoniae remain very low when compared with most European countries, resistance has increased since 2013.
- Vancomycin-resistant enterococci (VRE) is a major healthcare problem in Australia.
- Australia has higher rates of resistance to vancomycin in Enterococcus faecium when compared to more than 30 European countries, though rates have levelled off in recent years.
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.