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Antimicrobial stewardship: Prescribing across the primary care health professions

We examined the patterns of antibiotic prescribing by medical and non‐medical prescribers (dentists, nurse practitioners, and midwives) in Australia. We explored trends in the dispensed use of antibiotics (scripts and defined daily dose [DDD] per 1000 population/day) by Australian prescribers over t...

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Autores principales: Hollingworth, Samantha A., McGuire, Treasure, Van Driel, Mieke, Begum, Nelufa, Ford, Pauline J., Hawley, Glenda, Walsh, Laurence J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10245145/
https://www.ncbi.nlm.nih.gov/pubmed/37282986
http://dx.doi.org/10.1002/prp2.1106
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author Hollingworth, Samantha A.
McGuire, Treasure
Van Driel, Mieke
Begum, Nelufa
Ford, Pauline J.
Hawley, Glenda
Walsh, Laurence J.
author_facet Hollingworth, Samantha A.
McGuire, Treasure
Van Driel, Mieke
Begum, Nelufa
Ford, Pauline J.
Hawley, Glenda
Walsh, Laurence J.
author_sort Hollingworth, Samantha A.
collection PubMed
description We examined the patterns of antibiotic prescribing by medical and non‐medical prescribers (dentists, nurse practitioners, and midwives) in Australia. We explored trends in the dispensed use of antibiotics (scripts and defined daily dose [DDD] per 1000 population/day) by Australian prescribers over the 12‐year period, 2005–2016. We obtained data on dispensed prescriptions of antibiotics from registered health professionals subsidized on the Pharmaceutical Benefits Scheme (PBS). There were 216.2 million medical and 7.1 million non‐medical dispensed prescriptions for antibiotics over 12 years. The top four antibiotics for medical prescribers were doxycycline; amoxicillin, amoxicillin plus clavulanic acid, and cefalexin, constituting 80% of top 10 use in 2005 and 2016; the top three for non‐medical were amoxicillin, amoxicillin plus clavulanic acid and metronidazole (84% of top 10 use in 2016). The proportional increase in antibiotic use was higher for non‐medical than medical prescribers. While medical prescribers preferentially prescribed broad‐spectrum and non‐medical prescribers moderate‐spectrum antibiotics, there was a large increase in the use of broad‐spectrum antibiotics over time by all prescribers. One in four medical prescriptions were repeats. Overprescribing of broad‐spectrum antibiotics conflicts with national antimicrobial stewardship initiatives and guidelines. The proportional higher increase in antibiotic use by non‐medical prescribers is a concern. To reduce inappropriate use of antibiotics and antimicrobial resistance, educational strategies targeted at all medical and non‐medical prescribers are needed to align prescribing with current best practice within the scope of practice of respective prescribers.
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spelling pubmed-102451452023-06-08 Antimicrobial stewardship: Prescribing across the primary care health professions Hollingworth, Samantha A. McGuire, Treasure Van Driel, Mieke Begum, Nelufa Ford, Pauline J. Hawley, Glenda Walsh, Laurence J. Pharmacol Res Perspect Original Articles We examined the patterns of antibiotic prescribing by medical and non‐medical prescribers (dentists, nurse practitioners, and midwives) in Australia. We explored trends in the dispensed use of antibiotics (scripts and defined daily dose [DDD] per 1000 population/day) by Australian prescribers over the 12‐year period, 2005–2016. We obtained data on dispensed prescriptions of antibiotics from registered health professionals subsidized on the Pharmaceutical Benefits Scheme (PBS). There were 216.2 million medical and 7.1 million non‐medical dispensed prescriptions for antibiotics over 12 years. The top four antibiotics for medical prescribers were doxycycline; amoxicillin, amoxicillin plus clavulanic acid, and cefalexin, constituting 80% of top 10 use in 2005 and 2016; the top three for non‐medical were amoxicillin, amoxicillin plus clavulanic acid and metronidazole (84% of top 10 use in 2016). The proportional increase in antibiotic use was higher for non‐medical than medical prescribers. While medical prescribers preferentially prescribed broad‐spectrum and non‐medical prescribers moderate‐spectrum antibiotics, there was a large increase in the use of broad‐spectrum antibiotics over time by all prescribers. One in four medical prescriptions were repeats. Overprescribing of broad‐spectrum antibiotics conflicts with national antimicrobial stewardship initiatives and guidelines. The proportional higher increase in antibiotic use by non‐medical prescribers is a concern. To reduce inappropriate use of antibiotics and antimicrobial resistance, educational strategies targeted at all medical and non‐medical prescribers are needed to align prescribing with current best practice within the scope of practice of respective prescribers. John Wiley and Sons Inc. 2023-06-07 /pmc/articles/PMC10245145/ /pubmed/37282986 http://dx.doi.org/10.1002/prp2.1106 Text en © 2023 The Authors. Pharmacology Research & Perspectives published by British Pharmacological Society and American Society for Pharmacology and Experimental Therapeutics and John Wiley & Sons Ltd. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Articles
Hollingworth, Samantha A.
McGuire, Treasure
Van Driel, Mieke
Begum, Nelufa
Ford, Pauline J.
Hawley, Glenda
Walsh, Laurence J.
Antimicrobial stewardship: Prescribing across the primary care health professions
title Antimicrobial stewardship: Prescribing across the primary care health professions
title_full Antimicrobial stewardship: Prescribing across the primary care health professions
title_fullStr Antimicrobial stewardship: Prescribing across the primary care health professions
title_full_unstemmed Antimicrobial stewardship: Prescribing across the primary care health professions
title_short Antimicrobial stewardship: Prescribing across the primary care health professions
title_sort antimicrobial stewardship: prescribing across the primary care health professions
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10245145/
https://www.ncbi.nlm.nih.gov/pubmed/37282986
http://dx.doi.org/10.1002/prp2.1106
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