'Antibiotics don’t cure colds': Calls for prescription crackdown
Originally published on The Sydney Morning Herald
Many Australians have a stack of paper prescriptions stuffed in a drawer or at the bottom of a cupboard – either leftover repeats or scripts that haven't been filled but are yet to expire.
Now a leading expert on drug resistance has suggested that in numerous cases, prescriptions for antibiotics should not be offered on repeat, nor handed over with a lengthy, 12-month expiry.
It comes after evidence tens of thousands of patients could be hoarding their scripts and using them months later to treat an unrelated illness. In other cases, patients are receiving repeats for antibiotics when it is not medically required.
Professor Karin Thursky, director of the National Centre for Antimicrobial Stewardship, said a review of longstanding drug prescriptions at a Melbourne aged-care facility unearthed a resident who had been on antibiotics for more than a decade.
“[She] had been on doxycycline for over 10 years because she had happened to have a chest infection in the setting of owning a parrot in the past, and it was never stopped,” Professor Thursky said.
Unnecessary prescribing of antibiotics is of growing and grave concern because of the phenomenon of drug resistance, which threatens to render our current range of antibiotics useless.
Without antibiotics, the world is at risk of returning to the dark-ages of medicine, where even minor cuts could be life-threatening and many common medical procedures, such as cancer treatment, joint-replacement and caesarean sections, could become too dangerous to undertake.
It is estimated that without decisive action, by 2050, antimicrobial resistance will become the world’s biggest cause of death, killing 10 million people a year.
And deaths linked to drug resistance are already occurring, said Professor Thursky.
Speaking at the Victorian Healthcare Association conference recently, she recalled a case where a young woman with a genealogical cancer developed a drug-resistant yeast infection, which spread to her blood and delayed her chemotherapy and radiotherapy.
“In the end she ended up going to palliative care.”
One of the key problems continually highlighted by experts is that the public does not understand the seriousness of the threat and people continue to demand that their doctors prescribe them antibiotics for all types of ailments that don’t need them.
“We need people to understand that antibiotics don’t cure colds … and we need people to know that they must not hoard drugs or the scripts,” said Victorian Healthcare Association chief executive Tom Symondson.
“People think ‘I’ll hang on to those drugs because they will help me in six months’, but they are actually doing something that is very unhelpful.”
The national drug utilisation sub-committee has recommended that health officials consider removing prescription repeats for oral antibiotics and also reduce the expiry of these prescriptions to less than 12 months (with suggested alternatives anywhere between two weeks and three months).
It came after the committee found 19 per cent of prescriptions for the popular antibiotic amoxycillin were supplied more than 60 days after the original prescription was written.
The Royal Australian College of General Practitioners supports the idea of new date limits on prescriptions to prevent patients from taking an unnecessary second antibiotics course or using them later to treat unrelated ailments.
But the college's president Dr Bastian Seidel said the emphasis needed to be placed on public education and funding GPs to spend more time to explain to patients how they should use the medicines prescribed to them.
It’s a view shared by Professor Thursky.
“I don’t think our health system always allows for that focus on spending time with the patient, because there is a discussion that needs to be had [along the lines of] ‘I don’t think you need antibiotics, but these are the things you can do’,” she said.