Register      Login
Australian Journal of Primary Health Australian Journal of Primary Health Society
The issues influencing community health services and primary health care
RESEARCH ARTICLE

Assessing the uptake and effectiveness of a quick reference guide to antibiotic prescribing in Australian general practice

Angus Thompson A D , Patrick O’Sullivan B , Elisabeth Banham C and Greg Peterson A
+ Author Affiliations
- Author Affiliations

A Pharmacy, School of Medicine, University of Tasmania, Hobart, Tas. 7001, Australia.

B Augusta Road Medical Centre, Lenah Valley, Tas. 7008, Australia.

C Kingborough Medical Centre, Kingston, Tas. 7050, Australia.

D Corresponding author. Email: angus.thompson@utas.edu.au

Australian Journal of Primary Health 22(6) 565-568 https://doi.org/10.1071/PY15182
Submitted: 16 December 2015  Accepted: 5 March 2016   Published: 8 July 2016

Abstract

Prescribing guidelines are an essential component of antimicrobial stewardship programs in Australian hospitals. Nonetheless, the majority of antibiotic prescribing occurs in the community and the effectiveness of guidelines developed specifically to meet the needs of Australian general practice is unknown. This study aims to assess the uptake and effectiveness of a quick reference guide to antibiotic prescribing among primary care prescribers. A quick reference guide to antibiotic prescribing was developed and prescribers in five Tasmanian practices were surveyed regarding use of this guide. Thirty-three surveys were returned and, of those answering specific sections, 75% were aware of the guide and 71% had used it within the last month. The guide affected the antibiotic prescribing practice of 74% of responding prescribers; most often on choice of antibiotic; but also on duration of treatment, dose and dosing frequency. A quick reference guide to antibiotic prescribing was well received by prescribers and may usefully support efforts to improve antimicrobial stewardship in the community.

Additional keywords: antimicrobial, community, guidelines, stewardship.


References

Australian Commission on Safety and Quality in Health Care (2011) Antimicrobial Stewardship Initiative. Available at www.safetyandquality.gov.au/our-work/healthcare-associated-infection/ antimicrobial-stewardship [Verified 01 April 2015]

Basedow M, Runciman WB, Lipworth W, Esterman A (2015) Australian general practitioner attitudes to clinical practice guidelines and some implications for translating osteoarthritis care into practice. Australian Journal of Primary Health
Australian general practitioner attitudes to clinical practice guidelines and some implications for translating osteoarthritis care into practice.Crossref | GoogleScholarGoogle Scholar | 26434496PubMed | [Published online 5 October 2015].

Cabana MD, Rand CS, Powe NR, Wu AW, Wilson MH, Abboud P-AC, Rubin HR (1999) Why don’t physicians follow clinical practice guidelines? A framework for improvement. Journal of the American Medical Association 282, 1458–1465.
Why don’t physicians follow clinical practice guidelines? A framework for improvement.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3c%2FgsVSqtw%3D%3D&md5=d7d9b96621a8c48adb9e1eeba99d6b41CAS | 10535437PubMed |

Charani E, Holmes AH (2013) Antimicrobial stewardship programmes: the need for wider engagement. BMJ Quality & Safety 22, 885–887.
Antimicrobial stewardship programmes: the need for wider engagement.Crossref | GoogleScholarGoogle Scholar |

Commonwealth of Australia (2015) National Antimicrobial Resistance Strategy 2015–2019. Available at http://www.health.gov.au/internet/main/publishing.nsf/Content/ohp-amr.htm#tocstrategy [Verified 15 December 2015]

Gottlieb T, Nimmo GR (2011) Antibiotic resistance is an emerging threat to public health: an urgent call to action at the Antimicrobial Resistance Summit 2011. The Medical Journal of Australia 194, 281–283.

Kaufmann SHE (2008) Paul Ehrlich: founder of chemotherapy. Nature Reviews. Drug Discovery 7, 373
Paul Ehrlich: founder of chemotherapy.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BD1cXlt1agurc%3D&md5=9ed467664701f78c07d563f7b9306c09CAS |

Keith T, Saxena S, Murray J, Sharland M (2010) Risk–benefit analysis of restricting antimicrobial prescribing in children: what do we really know? Current Opinion in Infectious Diseases 23, 242–248.
Risk–benefit analysis of restricting antimicrobial prescribing in children: what do we really know?Crossref | GoogleScholarGoogle Scholar | 20375892PubMed |

Leung E, Weil DE, Raviglione M, Nakatani H (2011) The WHO policy package to combat antimicrobial resistance. Bulletin of the World Health Organization 89, 390–392.
The WHO policy package to combat antimicrobial resistance.Crossref | GoogleScholarGoogle Scholar | 21556308PubMed |

Llor C, Cots JM, González López-Valcárcel B, de Dios Alcántara J, García G, Arranz J, Monedero MJ, Ortega J, Pineda V, Guerra G, Gómez M, Hernández S, Paredes J, Cid M, Pérez C (2011) Effect of two interventions on reducing antibiotic prescription in pharyngitis in primary care. The Journal of Antimicrobial Chemotherapy 66, 210–215.
Effect of two interventions on reducing antibiotic prescription in pharyngitis in primary care.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC3cXhsFylurvK&md5=fb1e47b095d35182ddca128153c8dc64CAS | 21081543PubMed |

Llor C, Cots JM, Gonzalez Lopez-Valcarcel B, Arranz J, García G, Ortega J, Gómez M, Guerra G, Monedero MJ, Alcántara JD, Paredes J, Hernández S, Cid M, Pérez C, Pineda V (2012) Interventions to reduce antibiotic prescription for lower respiratory tract infections: Happy Audit study. The European Respiratory Journal 40, 436–441.
Interventions to reduce antibiotic prescription for lower respiratory tract infections: Happy Audit study.Crossref | GoogleScholarGoogle Scholar | 22183489PubMed |

Lugtenberg M, Zegers-van Schaick JM, Westert GP, Burgers JS (2009) Why don’t physicians adhere to guideline recommendations in practice? An analysis of barriers among Dutch general practitioners. Implementation Science; IS 4, 54
Why don’t physicians adhere to guideline recommendations in practice? An analysis of barriers among Dutch general practitioners.Crossref | GoogleScholarGoogle Scholar | 19674440PubMed |

McKenzie D, Rawlins M, Del Mar C (2013) Antimicrobial stewardship: what’s it all about? Australian Prescriber 36, 116–120.
Antimicrobial stewardship: what’s it all about?Crossref | GoogleScholarGoogle Scholar |

Murphy M, Byrne S, Bradley CP (2011) Influence of patient payment on antibiotic prescribing in Irish general practice: a cohort study. The British Journal of General Practice 61, 549–555.
Influence of patient payment on antibiotic prescribing in Irish general practice: a cohort study.Crossref | GoogleScholarGoogle Scholar |

NPS MedicineWise (2012) Medicine Wise News 77: antibiotic resistance – a problem for everyone. Available at www.nps.org.au/news_77 [Verified 01 April 2015]

Public Health England (2015) Management of infection guidance for primary care for consultation and local adaptation. Available at https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/377509/PHE_Primary_Care_guidance_14_11_14.pdf [Verified 01 April 2015]

Therapeutic Guidelines (2014) ‘Antibiotic’, 15th edn. (Therapeutic Guidelines Ltd: Melbourne)