gioia said:
Thanks COREYW,
May I ask you a question? Didn't literature appear, say 5 years ago, highlighting the increase of antibiotic resistance in Australia (due to OTC self-treatment)? I'm only curious, not accusatory, and the area mentioned was outside of Sidney... The article was comparing US over-administration of antibiotics in peds with similar probs. in the Western World.
Hi Gioia,
Good question. I'm not familiar with the study you allude to, but others I've seen show that antibiotic resistance is generally on the rise in Australia, just as everywhere else. Australian medicos' use of antibiotics (esp. broad spectrum) was much higher than the US and Canada, and much much higher than the UK in the late 90's. It's now started to plateau, but my sense (and I'm not a physician) is that GPs especially still tend to over-prescribe for minor self-limiting ailments of viral/bacterial aetiology, and many still don't educate their patients in the propert use of antibiotics, which may be part of the cause of growing resistance.
It's very difficult to self-prescribe antibiotics in most parts of Australia.
A 1999 government-appointed joint committee found that resistance was on the up for two main reasons: 1) over-prescription and 2) transfer of resistance from non-humans to humans (fully two-thirds of the mass of antibiotics used in Australia are used by the livestock industries).
http://www.health.gov.au/pubhlth/strateg/jetacar/present2.htm
A 1997 study found that:
"Antibiotic use in Australia remained steady between 1990 and 1995, with an estimated 24.7 DDDs/1000 population/day dispensed through community pharmacies in 1990 and 24.8 DDDs/1000 population/day in 1995. Amoxycillin, although declining in use, remained the most dispensed antibiotic. Compared with the other countries surveyed, Australia had the highest percentage use of tetracyclines, such as doxycycline, and the lowest percentage use of fluoroquinolones. Use of trimethoprim-sulfamethoxazole and flucloxacillin declined in Australia. In new cases of upper respiratory tract infection or pharyngitis, an antibiotic prescription was recorded for 57% of urban patient encounters and 73% of rural patient encounters.
"Antibiotic use in Australia is high, as in many other developed countries, but did not increase between 1990 and 1995. The overall profile of antibiotic use in Australia by drug class was similar to that in the United Kingdom. Antibiotics were still commonly prescribed for upper respiratory tract infection (which is usually viral), more commonly by rural than by urban general practitioners."
http://www.mja.com.au/public/issues/aug4/mcmanus/mcmanus.html
To their credit, the Royal Colleges and government health departments have apparently put quite a bit of effort into trying to spread the word on appropriate and judicious antibiotic use.
Word on the use of manual therapeutics and other complementary therapies for the treatment of URT and ENT infections has not spread however. Use of botanic medicine (esp echinacea) and nutritional supplements (esp. Vit.C and Zn) also appears to have risen, but there is precious little discussion, let alone collaboration between the 'natural medicine' and allopathic fields. Incidentally, there appears to have been a rise in the use of vaccinations for influenza, especially amongst the elderly, but the drug companies targeting anyone who 'can't afford to get sick.' (My parents - in their seventies and eighties - are this boat, and I'm very grateful for the flu jabs for their sakes!!!)
We're in the middle of our flu season here. I'm fending off a bug right now that's got a lot of folks laid up. Most of my peers (professionals) aren't running off to their GP, but are trying to take it easier, taking Echinacea and the usual plethora of cough lozenges and syrups, and painkillers. So, there's progress for you, but they are the more educated types.
Over-use or inappropriate use of antibiotics is a real bug-bear of mine
