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Campaign has guidance on when antibiotics should not be used

Campaign has guidance on when antibiotics should not be routinely used

The Council of Medical Colleges is supporting World Antibiotic Awareness Week, and encouraging clinicians to consider the Choosing Wisely recommendations on antibiotic use before prescribing.

Dr John Bonning from the Council of Medical Colleges Executive says overuse or incorrect use of antibiotics contributes to antibiotic resistance - when antibiotics lose their ability to effectively control or kill bacterial growth.

"A growing number of infections, such as pneumonia, tuberculosis, and gonorrhoea, are becoming harder to treat as the antibiotics used to treat them become less effective. Antibiotic resistance leads to longer hospital stays, higher medical costs and increased mortality.

"As part of the Choosing Wisely campaign, the Council has worked with Australasian and New Zealand Colleges and specialist societies to develop specific recommendations about antibiotic use. These recommendations include situations when antibiotics should not routinely be used - such as for upper respiratory tract infections, the use of topical antibiotics on surgical wounds, and for the treatment of fever in children without a bacterial infection."

The Choosing Wisely antibiotics use recommendations are:

Infectious diseases

-Do not use antibiotics in asymptomatic bacteriuria.

-Do not take a swab or use antibiotics for the management of a leg ulcer without clinical infection.

-Avoid prescribing antibiotics for upper respiratory tract infection.

Intensive care medicine

-Consider antibiotic de-escalation daily infection can precipitate a need for intensive care admission and can occur as a complication of an ICU admission.


-Do not use antimicrobials to treat bacteriuria in older adults where specific urinary tract symptoms are not present.


-Don’t use oral antibiotics for the treatment of atopic dermatitis unless there is clinical evidence of infection.

-Don’t routinely use topical antibiotics on a surgical wound.

Paediatrics and child health

-Do not routinely prescribe oral antibiotics to children with fever without an identified bacterial infection.

Dr Bonning says each recommendation is based on the best available evidence.

"The recommendations are not prescriptive but are intended as guidance to start a conversation about what is appropriate and necessary.

"As each situation is unique, health care professionals and patients should use the recommendations to develop together an appropriate health care plan."

The campaign also has resources for consumers, covering:

-Antibiotics for sinusitis

-Antibiotics for your skin

-Coughs, colds & sore throats - manage symptoms without antibiotics

-Ear infection - treatments.

Dr Bonning encourages health professionals to share these resources with patients.

The Choosing Wisely campaign is being run by the Council of Medical Colleges, in partnership with the Health Quality & Safety Commission and Consumer. A number of other medical organisations are supporting the campaign. The campaign emphasises that not all medications, tests, treatments and procedures bring benefits and encourages people to ask questions about their health care. For more information see:

World antibiotic awareness week is an annual World Health Organization event, this year held 13-19 November. This year’s theme is ‘Seek advice from a qualified health professional before taking antibiotics’.


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