WA News Letters AM resistance in RACFs
AM resistance in RACFs
Written by Dr Lynn Weekes
Tuesday, 29 November 2016

Dear Editor,

The article, Resistant Gram negatives – a growing threat (November) highlights the importance of judicious antibiotics use among residents in aged care facilities. Antimicrobial resistance is a growing concern.

One area where NPS MedicineWise believes progress can be made is in the management of urinary tract infections. Excessive antibiotic use—in the context of asymptomatic bacteriuria—may be contributing to the high prevalence of multidrug-resistant E. coli seen in this group.

In aged-care facilities where there is a high prevalence of asymptomatic bacteriuria, diagnosing symptomatic UTI requires assessment of new presenting signs and symptoms. The patient’s existing medicines and conditions should also be considered.

Patients with advanced dementia are of particular concern as they may have factors associated with harbouring antibiotic-resistant bacteria (such as faecal incontinence or skin ulcers). These patients also require significant assistance with activities of daily living and this can contribute to the spread of antibiotic-resistant bacteria to healthcare workers due to poor infection control.

Current evidence supports treating asymptomatic bacteriuria with antibiotics for those at risk of complications or who are to undergo procedures that involve the bladder or urethra.

Among other populations where asymptomatic bacteriuria is common, such as women aged over 60 years, catheterised patients in hospitals, people with diabetes and the elderly, a clinical benefit of antibiotic treatment is not evident.

Antibiotic resistance is a global threat and it behoves us all to rise to the challenge to handle antibiotics with care and help reduce its spread.

Dr Lynn Weekes, CEO, NPS MedicineWise