Antibiotics are underused in some patients in whom they would provide benefit and overused in others who could be harmed by unnecessary treatment. A core goal of antimicrobial stewardship (AMS) is to slow development of antibiotic resistance, which can also be thought of as antibiotic conservation – using antibiotics as well as we can to ensure these important medicines remain available and effective for our tamariki and mokopuna.
The Problem
At present there is no standard to both guide antibiotic prescribing and measure the appropriateness of treatment. While we know there are marked inequities in the rates of infections for Māori and Pacific peoples in Aotearoa, very little is known about the inequities in infection treatment.
Our Solution
We plan to develop a national antibiotic guideline in Aotearoa that sets out the optimal treatment of infections.
We will also develop innovative systems that automatically monitor antibiotic prescribing together with the reasons for prescribing antibiotics, and information about the populations for whom antibiotics were prescribed.
Using our new guideline and monitoring system, we will then determine the appropriateness of antibiotic prescribing for important infectious diseases in Aotearoa (e.g. sore throats, skin infections, meningitis), with particular attention to prescribing for Māori, Pacific peoples and other population groups who bear a disproportionate burden of infectious disease in Aotearoa.
Finally, we will work collaboratively with Māori health providers, and with hospital and community-based clinicians to determine how best to provide prescriber feedback about antibiotic prescribing and will assess the impact of feedback on prescribing practice. Our partnership with Te Niwha will provide the foundation for improving antibiotic use in Aotearoa. Improving antibiotic use via antimicrobial stewardship efforts in Aotearoa is critical to reducing the threat of antibiotic resistance, reducing harm, enhancing equitable care, and improving patient outcomes.
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