‘Repeat’ prescriptions and antibiotic resistance: findings from Australian community pharmacy

Abstract

Australians are among the highest users of antibiotics in the developed world. The primary aim was to determine the 'age' of antibiotic prescriptions at the time of dispensing as a possible contributor to antibiotic misuse and ultimately, resistance. The secondary aim was to test customised software to permit extraction and de-identification of dispensing records for analysis. Data were extracted and de-identified from computerised dispensing systems in three community pharmacies in Brisbane, Australia, according to a strict ethical protocol. All prescription records dispensed between 1 January 2010 and 31 December 2012 were merged to form a complete dataset of 1158871 de-identified dispensing records which were analysed using Microsoft Excel® . A retrospective drug utilisation study was conducted on a subset of 100573 antibiotic records. In a substudy conducted at a single pharmacy site, all antibiotic records dispensed over a 4-month (winter) period were examined to determine the age of prescriptions. Nearly one in ten antibiotics (9.0%) was dispensed from prescriptions that were more than a month old, and over one in five (22.1%) were dispensed from a repeat prescription. Health system factors may contribute to inappropriate antibiotic use in Australia, including availability and validity of repeat antibiotic prescriptions. Government health departments, prescribers, pharmacists, other health professionals and consumers have to share the responsibility of ensuring that antibiotics are used appropriately.