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The pills that are killing you

Abuse and inappropriate prescription of opioids and antibiotics have been recognised as a threat to the public. Opioid overdoses are now killing three Australians a day on average. Around one-third of antibiotic prescriptions have been assessed as non-compliant with treatment guidelines and one in four have been deemed inappropriate. 

The Antimicrobial prescribing practice in Australian hospitals: Results of the 2017 Hospital National Antimicrobial Prescribing Survey released today by the Australian Commission on Safety and Quality in Health Care, is a report aimed at improving the use of antibiotics in Australian hospitals.

The 2017 report summarises the results of a voluntary audit of 314 hospitals across Australia, and analysis of 26,277 prescriptions for 17,366 patients.

To help promote responsible use of antibiotics, the commission analyses prescribing patterns and infection data, working with the medical sector to improve clinical care.

While the report revealed that there have been some improvements in hospital practices over the past five years, it also found that other strategies are fuelling resistance to antibiotics and other antimicrobials, which now poses a critical threat to public health.

Compliance with antibiotic guidelines declined from 72.2 per cent in 2013 to 67.3 per cent in 2017. Almost one quarter (23.5 per cent) of prescriptions were assessed as inappropriate, and almost one third (32.7 per cent) were non-compliant with guidelines.

Inappropriate use and abuse of antibiotics encourages resistance to these medicines, and contributes to the spread of superbugs.

“Overuse and inappropriate use of antimicrobials is a key factor contributing to bacteria and other pathogens becoming unresponsive to last-line drugs,” said Dr Kathryn Daveson, clinical director of the AURA Program at the Commission.

“These results are hugely concerning as ongoing inappropriate use of antibiotics assists bacteria to evolve increased resistance to existing antibiotics. This misuse places a heavy burden across the population, with a disproportionate impact on vulnerable communities, such as aged-care residents and people in rural and remote areas.

“Clinicians are already seeing the impact of antimicrobial resistance, with increasing challenges in treating people for common illnesses. Ultimately, we may lose the effectiveness of antibiotics to keep us healthy when we most need them,” she said.

The commission hopes to promote the responsible use of antimicrobial drugs, including antibiotics and antifungals, to address increasing rates of drug-resistant infections.

“We need to improve prescribing to keep patients safe and reduce the impact of antimicrobial resistance,” said Associate Professor Kirsty Buising, deputy director of National Centre for Antimicrobial Stewardship (NCAS).

Opioids are also harming or killing Australians, with an Australian Institute of Health and Welfare (AIHW) report showing that three people a day die from their misuse.

A national strategy to combat addiction included bans on purchases of over-the-counter codeine, but it seems that where there’s a will there’s a way, with one in 10 people believed to be using illegal opioids or misusing prescription drugs.

So far, the number of opioid-related deaths in 2016, the most recent year for which data was available, hit 1119 – the highest death toll since a peak of 1245 in 1999.

“Every day in Australia, there are nearly 150 hospitalisations and 14 presentations to emergency departments involving opioid harm, and three people die from drug-induced deaths involving opioid use,” said AIHW spokeswoman Lynelle Moon.

“The number of deaths involving opioids has nearly doubled in the decade to 2016, from 591 to 1119. Put another way, this is a rise from about three deaths involving opioids in every 100,000 people to about five.”

Opioid-related deaths are now more likely than fatalities caused by illicit substances, and the same applies to hospitalisations, which increased 25 per cent over the decade.

Last year, 15.4 million opioid prescriptions were dispensed to 3.1 million people under the Pharmaceutical Benefits Scheme. Oxycodone, otherwise known as ‘Hillbilly Heroin’, which many older Australians use to treat moderate and severe pain, was the most commonly dispensed prescription opioid.

How careful are you with your prescriptions? Are you shocked by the number of deaths caused by opioid misuse? Do you take antibiotics whenever they are prescribed to you? Or do you question your prescription?

Related articles:
Do you really need antibiotics?
Accidental overdoses on the rise
The perils of painkillers

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