Title Algorithms could help reduce avoidable antibiotic prescribing Media name/outlet News GP Country/Territory Australia Date 9/01/24 Description A digital tool has led overseas doctors to slash prescription numbers by 46%, but there are doubts about its application in Australia...
However, Professor Mark Morgan, Chair of RACGP Expert Committee – Quality Care, told newsGP while there is a need to improve primary care antibiotic stewardship, he said ‘simple algorithms that score points for certain clinical features can be very hit and miss’.
‘In clinical practice the decision to prescribe is a complex one that involves numerous data points from the history and clinical examination,’ he said.
‘These are then overlaid by patient ideas, expectations, and social setting. It is often disappointing to reduce this to an over-simplified scoring system.
‘Any combination of point-of-care testing and clinical feature checklist would need to be carefully evaluated in many and varied Australian settings to understand how it works on the ground.’...
Aside from the overuse of antibiotics contributing to the rise of ‘superbugs’, Professor Morgan said resistance is also worsening as organisms are spread around the world by travel.
‘Avoiding low-value or too broad-spectrum antibiotic use is one of the ways to slow the development and spread of antimicrobial resistance,’ he said.
‘Antimicrobial stewardship is also important for the individual patient and their household because antibiotic use leads to selective advantage for any superbugs.’
Professor Morgan said there is no ‘magic bullet’ to improve primary care antibiotic stewardship, but there are many strategies GPs can utilise.
In 2022, he co-authored a review of successful evidence-based strategies to improve primary care antibiotic stewardship, ultimately finding a suite of strategies are needed.
‘These included pack size and prescribing restrictions, public and clinician awareness campaigns and clinical strategies such as clinical decision support, audits and patient information sheets,’ Professor Morgan said.
‘The use of point-of-care testing for C-reactive protein, procalcitonin and streptococcal infections can help identify which patients are most likely to benefit from antibiotics, but it costs time and money to do this.’
Producer/Author Michelle Wisbey URL https://www1.racgp.org.au/newsgp/clinical/algorithms-could-help-reduce-avoidable-antibiotic?utm_source=racgpnewsgpnewsletter&utm_campaign=newsgpedm&utm_medium=email Persons Mark Morgan