Longer exposure to antibiotics can contribute to resistance: NPS MedicineWise (Pharmacists)

2 JULY 2013

The continued overuse and misuse of antibiotics means that one day we risk losing the effect of these vital medicines.

To help prescribers play their role in the fight against antibiotic resistance, NPS MedicineWise has published information on the importance of specifying the optimal duration of antibiotic therapy — both on prescriptions and in discussions with patients.

NPS MedicineWise clinical adviser Dr Philippa Binns says that good prescribing practices can minimise antibiotic resistance in the community.

“One way to stop the progress of antibiotic resistance is to restrict the use of antibiotics and minimise the duration of therapy when possible,” says Dr Binns.

“The goal should be to prescribe antibiotics when benefits are likely to be substantial. Heading into cold and flu season, this especially means for GPs to be mindful about not prescribing antibiotics when an uncomplicated viral infection or self limiting bacterial infection is diagnosed.

“For bacterial infections requiring antibiotics, the duration of antibiotic therapy needs to be sufficient to control the bacterial infection and prevent relapse, and of course you need to consider the nature and severity of the infection and the person’s immune status. But overall, the shorter the duration of antibiotic treatment, the less likely a person will develop resistance.

“It’s important to note that for some infections, such as Staphylococcus aureus bacteraemia, endocarditis, osteomyelitis or tuberculosis, clear evidence favours prolonged treatment to prevent relapse.”

The recent issue of the monthly NPS MedicineWise e-newsletter for health professionals NPS Direct suggests prescribers refer to antibiotic guidelines (Therapeutic Guidelines: Antibiotics and Australian Medicines Handbook) for the recommended duration of antibiotic therapy or, where applicable, to local evidence-based guidelines.

Patient communication is also paramount to help prevent antibiotic resistance, and doctors should clearly outline the duration of treatment when prescribing antibiotics.

“Specify the duration of treatment on the prescription, help your patient understand how long they should take them and explain that it is important to not exceed this length of time,” says Dr Binns.

“Sometimes this means there will be antibiotics left over in the packet or bottle, so let your patients know they can return unused medicines to the pharmacy.”

Further ideas to help avoid patient confusion include not providing a repeat on the prescription unless required, considering removing the default for repeat prescription in medical software, and considering specifying an expiry date on prescriptions to prevent them from being filled after you anticipate the infection will be resolved.

To read the full NPS Direct article ‘Duration of antibiotic therapy and resistance’ go to www.nps.org.au/antibiotics-how-long

For more information about antibiotic resistance, and to view all NPS MedicineWise resources on this topic, visit www.nps.org.au/antibiotic-medicines


Independent, evidence-based and not-for-profit, NPS MedicineWise enables better decisions about medicines and medical tests. We are funded by the Australian Government Department of Health and Ageing.

Media enquiries: Stephanie Childs on 02 8217 8667, 0419 618 365 or schilds@nps.org.au or Erin Jardine on (02) 8217 8733 or ejardine@nps.org.au