Residents in Australian aged care facilities received more antibiotics in a year than residents in the United Kingdom, the Netherland and North America, a Macquarie University study has found.

The study, published in PLoS One, examined antibiotic use in residential aged care internationally through 90 articles representing 78 studies between 1985 and 2019.

The study found that 68 per cent of Australian aged care residents received an antibiotic over a 12-month period, which was a higher proportion than residents in the United Kingdom and Ireland (54 per cent) and the Netherlands and North America (63 per cent).

Lead researcher Dr Magda Raban said the results were concerning.

“It tells us that we’re using antibiotics too frequently in Australian residential aged care and we need very targeted initiatives to try and reduce this,” Dr Raban told Australian Ageing Agenda.

“We know that overuse of antibiotics leads to antimicrobial resistance. But it also can lead to adverse effects in the residents that are taking them,” said Dr Raban, a senior research fellow at Macquarie University’s Australian Institute of Health Innovation.

Aged care residents are already more susceptible to having adverse effects because they are older,  Dr Raban said.

Dr Magda Raban

“They’re also usually on a number of medications and adding an antibiotic to that can interfere with both medications as well,” she said.

The research also found that only 29 per cent of antibiotic use in aged care homes in Australia and overseas was appropriate.

Dr Raban said the findings highlighted the need to better address antibiotic use in residential aged care.

“It points to the fact that there is room for improvement in terms of antibiotic use,” Dr Raban said.

The study found that penicillin, cephalosporin and trimethoprim are the top three antibiotic classes used in Australian residential aged care facilities while quinolines is more common in North America, Western Europe, Southern Europe and Eastern Europe.

This is where Australia performs better than other regions, Dr Raban said.

“The good news here is that the antibiotics that are used in Australia are not… high risk for antimicrobial resistance antibiotics. So in terms of that in Australia, we perform better than other regions because other regions’ use classes such as quinolones, which are meant to have more restricted use,” Dr Raban said.

She said quinolines should only be used “at the second line” and infrequently.

Australian hospitals have targeted programs to ensure appropriate antibiotic use but this is lacking in residential aged care, Dr Raban said.

There needs to be specific initiatives for aged care providers to reduce  the unnecessary use of antibiotics, such as linking IT systems to provide real-time data, she said.

Dr Raban said the current problem is that digital systems collect a lot of data that remains locked within the system.

“We need to work out a way that we can have that data readily available for the providers to use,” she said.

“With our work, we are trying to focus on how digital systems can play an important role with this in this area and how a well-designed system would be able to provide decision support at various points in the care process.

“Ideally with these systems, aged care providers should be able to monitor their antibiotic use,” Dr Raban said.

Access the study.

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