Driving judicious use of antibiotics in Australia
Each year, large quantities of antibiotics are prescribed in Australia for the treatment of suspected infection. Yet, alarmingly, many infection-causing pathogens are becoming increasingly resistant to antibiotics. The World Health Organization (WHO) predicts that if action isn’t taken to prevent antimicrobial resistance, it will be responsible for 10 million deaths by 2050.
The National Centre for Antimicrobial Stewardship (NCAS) is a National Health and Medical Research Council (NHMRC)-funded Centre of Research Excellence, and was established at the Doherty Institute in 2015. The aim of NCAS is to understand current prescribing behaviour, and develop, implement and evaluate practical strategies to improve the way that antimicrobial drugs are used within Australia.
“We’ve been able to get to the crux of the issues in each of the streams across human health and animal health,” says Professor Karin Thursky, Director of NCAS.
NCAS has investigated the quality of antimicrobial use, and the barriers to and enablers of appropriate optimal antimicrobial prescribing in human and animal health settings, acute and primary care settings, metropolitan and rural-regional settings, veterinary and agricultural settings, and different patient groups.
“We’ve approached research questions at NCAS using quantitative and qualitative data to understand prescribing practices, and attitudes and behaviours around what healthcare workers, vets and others are prescribing, and their reasons for doing so,” says Professor Thursky.
Central to the work of NCAS is the concept of ‘one health,’ which recognises that the health of humans, animals and the environment are all unified and interconnected.
“We’re driving change. We’ve generated a lot of knowledge that’s now driving government programs and new antimicrobial stewardship initiatives in human and animal health sectors. One of our pioneering translational achievements has been the development of independent and evidence-based antimicrobial prescribing guidelines for use in veterinary medicine in Australia.”
NCAS is working with government to disseminate clinical prescribing guidelines and antimicrobial stewardship educational resources and courses across the animal health sector in Australia. NCAS is also working on building infection control and antimicrobial stewardship capacity among farmers and livestock veterinarians.
“We’ve also contributed to the introduction of antimicrobial stewardship in hospital and aged care home accreditation criteria. Hospitals are required to monitor and review their antimicrobial prescribing. Additionally, hospitals are now coming to us to understand what they can do to improve antimicrobial prescribing.
“We’re also starting to better understand how we can support primary care clinicians to use antibiotics in the best way – so we’re actively working on the necessary tools to assist them,” Professor Thursky concludes.