16 Jul 2024

Doctors urged to reflect on antibiotics prescriptions amid overuse warning

6:10 pm on 16 July 2024

Doctors are being urged to go easy on prescribing antibiotics for patients who don't need them, amid fears about the rise in antibiotic-resistant infections.

The latest briefing from the Public Health Communication Centre warned New Zealand has one of the highest rates of antibiotic resistance, which made it harder to treat people with pneumonia, skin abscesses, kidney infections and meningitis.

It pointed out that those hardest hit would be the communities with the highest overall rates of antibiotic use, currently Pacific and Māori whānau.

Royal College of GPs president Dr Samantha Murton said antibiotics prescribing has been an issue for some time.

Dr Samantha Murton

Samantha Murton Photo: Royal New Zealand College of GPs

Around two years ago doctors were reminded they should be reviewing how often they prescribed them.

"It's been a constant issue," she told Checkpoint.

Doctors sometimes found it hard to say no on a regular basis while seeing patients every day.

"We try and be as cautious as we can but people often come in with an expectation ... there is a little bit of pressure on us to prescribe at times."

If patients had been unwell for a week or two, it was hard to tell them to go home and make do with a simple remedy such as hot water and honey.

Māori and Pacific were at high risk of sore throats that could be strep throat which could lead to the infection causing heart damage. Ideally, swabs should be carried out to determine if antibiotics were necessary, Murton said.

"But the general rule is for people who are high risk you'd give them antibiotics anyway to reduce the risk of having an infection going to their heart."

Doctors had to balance out the risk while looking after the most vulnerable people, Dr Murton said.

"So it's a real balancing act."

It must also be remembered that doctors were not the only ones prescribing antibiotics - pharmacists were among those able to provide them in some instances.

Different tablets

Photo: 123RF

She advised all health professionals to consider their pattern of prescribing and medical centres should also review what was happening among their staff.

She recalled letters being sent a few years ago to the country's GPs who had the highest rates.

"I think all of us - reflective practice and looking at what we do and then going: 'I'm an outlier' is a really important part of reducing prescriptions that are unnecessary."

Dr Murton said other solutions included offering patients reassurance, testing before prescribing, prescribing short rather than lengthy courses of antibiotics and also trying to educate patients about whether or not they were really required.

Get the RNZ app

for ad-free news and current affairs