Australia’s overuse of antibiotics found to be driving rate of drug-resistant infections

Australia’s continued overuse of antibiotics is driving common and potentially dangerous infections to become increasingly resistant to drugs, including last resort treatments.

A major government report on antimicrobial use, published on Wednesday, found more than one-third (36.6%) of the population had at least one antimicrobial prescription subsidised by the Australian government in 2022, up from 32.9% in 2021.

The misuse and overuse of antibiotics and antifungals is driving bugs to mutate so that common drugs are no longer effective to kill them, a phenomenon known as antimicrobial resistance.

Drug resistant infections kill “hundreds” of Australians each year, the report from the Australian Commission on Safety and Quality in Health Care found.

Australia ranks seventh-highest in the developed world for antimicrobial community prescribing rates. Australia’s hospital antimicrobial use is estimated to be nearly three times that of the European country with the lowest use, the Netherlands.

The report attributed this high prescribing to “ongoing lack of improvement in the appropriateness of prescribing in public and private hospitals”. The drugs were being overused to prevent infections during and post-surgery, and the report found there was also “increasing antifungal use in hospitals, which could drive resistance in the future”.

A senior medical adviser for the commission, infectious diseases physician Prof Peter Collignon, said there was also a “cultural expectation in Australia that there’s a pill or a tablet for every problem”.

But antibiotics do not work against viruses, such as those that can cause colds and flu, with rest and treating symptoms often the best option.

“The reality is we’re giving out a lot of antibiotics when we don’t need to, Collignon said.

“People need to realise if you’re taking antibiotics when they’re not needed it can drive the rise in superbugs, which can then be spread to others. There can also be side effects from use in about 5% of people and, while these are usually minor, some can be serious.

“So there are a lot of good reasons to change the culture and start to ask questions every time we are prescribed an antibiotic, such as ‘Do I definitely have an infection that can be treated with this?’”

While the report found antimicrobial use in the community fell significantly, and for the first time in 2020 and 2021, this was largely due to the Covid-19 pandemic which saw public health measures such as lockdowns, mask wearing and social distancing lead to less sickness overall and less need for treatments.

Prescribing rates began rising again in 2022, with antimicrobial use highest in Queensland, New South Wales and Victoria. Collignon said it was important people continued to maintain good hygiene regardless of the pandemic including frequent hand washing and staying home when sick.

The report described common pathogens such as gonorrhoea, golden staph and E coli as increasingly resistant to common antibiotics.

Meanwhile, a number of pathogens have been reported by laboratories as increasingly failing to respond to last-line antimicrobial drugs. The most common of these was CPE, a bacteria that in rare cases can invade the blood or tissues and cause serious infections. Nationally, there was a 37.4% increase in reports of CPE being resistant to last-line treatments in 2022 compared with 2021.

The World Health Organization estimates that antimicrobial resistance could result in up to 10m deaths each year by 2050.