There's growing calls from experts to reduce New Zealand's dangerously high use of antibiotics.
The Public Health Communication Centre says the nation has some of the highest rates of antibiotic resistance, which makes bacterial infections difficult to treat.
It's urging the Ministry of Health and College of Practitioners to set targets to reduce the unnecessary prescribing of antibiotics.
Auckland University's Mark Thomas says GPs and patients alike feel more pressure to utilise antibiotics, despite increased awareness surrounding the risks.
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Speaker 1 (00:00):
Jack team and a disease physician is calling on healthcare
leaders to stop prescribing antibiotics to patients who don't need them.
Professor Mark Thomas has warned that New Zealand currently has
one of the highest antibiotic resistance rates in the world.
His briefing has encouraged if Utter Order and the Royal
College of GPS to set goals to reduce inappropriate antibiotic
(00:22):
prescribing and disease physician Professor Mark Thomas is with us
this evening high Mark, Hi Jack, So, why is New
Zealand ranking so poorly when it comes to antibartic prescriptions
and antibartic resistance.
Speaker 2 (00:37):
It's just been a culture that has built up over
a long period of time, decades of gradually increasing, for
some decades rates of gradually increasing antibiotic prescribing for people
in the community. People in the community consume about ninety
five percent of all the antibiotics that are given to
people in New Zealand, so only five percent in hospitals.
(00:59):
Most of it's only and it's gradually gone up over
the years. It's actually peaked at about twenty and thirteen
twenty fourteen, and since then has been gradually coming down,
but it's but it had got up and it's still
is at high levels compared with most countries in the world.
Speaker 1 (01:16):
And so for what things are people being inappropriately prescribed antibotics?
Speaker 2 (01:23):
The things that most people are most commonly inappropriately prescribed
antibiotics are colds, the flu, cough, you know, an episode
of bronchitis, some children with mild episodes of titus media,
people who wouldn't get rheumatic fever but have a sore throat,
but have no risk of getting rheumatic fever from the
(01:43):
sore throat. So anybody who's not Mari or Pacific and
aged to thirty five, they shouldn't be getting antibotics for
a sore throat. So there's lots of what are called
upper respiratory tract infections. It's almost always caused by viruses.
Speaker 1 (01:57):
I mean, I would have thought most doctors are pretty
old year of the concerns around antibartic resistance, So why
would they be prescribing antibotics for colds and viruses?
Speaker 2 (02:08):
Well, you've got to think about it. It's a business interaction.
The patient is coming you, you don't have very much
time with them. As a general practitioner. You're under pressure
all the time. And some patients very strongly expect an
antibiotic for those sorts of infections. Others just don't know.
But it's sometimes difficult unless the GP asks, well, what
(02:28):
are you expecting? Do you want antibiotics or not? And
there's a time pressure, and for some patients there's the feeling, well,
I've come to see you, I've taken a lot of
time out of my day. My illness is dragged on.
I'm feeling terrible after five or six days, my snot's
gone green, I'm still coughing whatever else. Just give me
something neat or madam to fix it up. Yeah, and
(02:51):
quite a bit of pressure.
Speaker 1 (02:52):
Yeah, you can understand that.
Speaker 2 (02:54):
Yeah.
Speaker 1 (02:54):
So what are the gold standard countries for antibartic prescriptions
and how might we do a better job of emulating
their processes?
Speaker 2 (03:04):
The gold standard countries are the Netherlands, Sweden and some
of the other scan all much pretty much the other
Scandinavian countries, right, and what.
Speaker 1 (03:12):
Do they do well that we don't?
Speaker 2 (03:15):
Well, they don't. We have a big surge and antibiotic
prescribing through the autumn and winter and early spring months
when the viruses are spreading around a bit more because
we're more cramped up inside and they don't have a
big surge. Then they don't run a mark on giving
people antibiotics, you know during those months when people are
getting cops and colds, et cetera. Right, but they start
(03:36):
off with a lower baseline as well. Now we are
not the same as the Netherlands or Sweden. We have
a different population than them. We have more people, you know,
in relative poverty, and we have Marian passive people who
have a particular issue with getting rheumatic fever and some
other higher rate of all sorts of other infections as well.
(03:57):
So we will never get down to the same level
as them, but we could get closer to them without
having a deterioration in the health of the people of
New Zealand.
Speaker 1 (04:07):
So talk to us about how you understand the goals
for reducing antibodic prescriptions are going to work. Do you
understand how that's going to function?
Speaker 2 (04:16):
Yeah, I think if the Ministry of Health and or
the Royal College of General Practitioners said, we think that
a reduction each year of about five percent in the
rate of antibotic prescribing across the whole country would be
a good thing for a number of years. Then I
think GPS would respond to that encouragement, and I think
(04:37):
the general public would hear it and think, h yeah,
well we should be doing what they're saying. And I
won't put my GP under pressure. And maybe when I've
got a cold, I'll just stay at home because I
can look after myself perfectly well without getting given to
the doctor and expecting maybe some antibiotics.
Speaker 1 (04:52):
As someone who's got a lot of expertise in the
space professor, what do you think about as being a
worst case pussibility in the near future. When it comes
to antibiotic resistance, it is.
Speaker 2 (05:05):
A gradual thing. It's like, you know, pollution of rivers
and lakes with too much fertilizer. This is something the same.
It's pollution of the organisms or you know, a change
in the microbiome the families of bacteria that live in
us as a result of exposure to all the antibotics,
and it changes slowly, imperceptibly. That's why we tend to
forget about it. But it is changing. And what happens
(05:29):
is that eventually, and it's already happening to a very
small degree, but it's more overseas in some of the
countries that use even more antibotics than us. Is that
you see patients with bacterial infections and there's three or
four antibiotics that would have worked well against that bacterium
in the past, and there's none now that work against
that particular bacterium that that patient's got, and they end
(05:50):
up dying of the infection, or they end up having
to have the infected foot, for instance, cut off, because
you can't beat the infection with any antibiotics and so
you've just got to cut the foot off. So yeah,
those are those are the worst case scenarios that we
see increasing numbers of people with infections that can't be
treated and that cause catastrophe, and that will happen unfortunately
(06:15):
to the populations in New Zealand who have the highest
rates of infections and have the highest amount of anybodic treatment.
And that's going to be the relatively you know, underprivileged
people in our society and particularly Marian Pacific people. It
will be a terrible thing if we allow it to happen.
Speaker 1 (06:33):
Thank you so much for your time, We really appreciate it.
That is Professor Mark Thomas For more from Hither duplessy
Alan Drive, listen live to news talks it'd be from
four pm weekdays, or follow the podcast on iHeartRadio
Jack team and a disease physician is calling on healthcare
leaders to stop prescribing antibiotics to patients who don't need them.
Professor Mark Thomas has warned that New Zealand currently has
one of the highest antibiotic resistance rates in the world.
His briefing has encouraged if Utter Order and the Royal
College of GPS to set goals to reduce inappropriate antibiotic
(00:22):
prescribing and disease physician Professor Mark Thomas is with us
this evening high Mark, Hi Jack, So, why is New
Zealand ranking so poorly when it comes to antibartic prescriptions
and antibartic resistance.
Speaker 2 (00:37):
It's just been a culture that has built up over
a long period of time, decades of gradually increasing, for
some decades rates of gradually increasing antibiotic prescribing for people
in the community. People in the community consume about ninety
five percent of all the antibiotics that are given to
people in New Zealand, so only five percent in hospitals.
(00:59):
Most of it's only and it's gradually gone up over
the years. It's actually peaked at about twenty and thirteen
twenty fourteen, and since then has been gradually coming down,
but it's but it had got up and it's still
is at high levels compared with most countries in the world.
Speaker 1 (01:16):
And so for what things are people being inappropriately prescribed antibotics?
Speaker 2 (01:23):
The things that most people are most commonly inappropriately prescribed
antibiotics are colds, the flu, cough, you know, an episode
of bronchitis, some children with mild episodes of titus media,
people who wouldn't get rheumatic fever but have a sore throat,
but have no risk of getting rheumatic fever from the
(01:43):
sore throat. So anybody who's not Mari or Pacific and
aged to thirty five, they shouldn't be getting antibotics for
a sore throat. So there's lots of what are called
upper respiratory tract infections. It's almost always caused by viruses.
Speaker 1 (01:57):
I mean, I would have thought most doctors are pretty
old year of the concerns around antibartic resistance, So why
would they be prescribing antibotics for colds and viruses?
Speaker 2 (02:08):
Well, you've got to think about it. It's a business interaction.
The patient is coming you, you don't have very much
time with them. As a general practitioner. You're under pressure
all the time. And some patients very strongly expect an
antibiotic for those sorts of infections. Others just don't know.
But it's sometimes difficult unless the GP asks, well, what
(02:28):
are you expecting? Do you want antibiotics or not? And
there's a time pressure, and for some patients there's the feeling, well,
I've come to see you, I've taken a lot of
time out of my day. My illness is dragged on.
I'm feeling terrible after five or six days, my snot's
gone green, I'm still coughing whatever else. Just give me
something neat or madam to fix it up. Yeah, and
(02:51):
quite a bit of pressure.
Speaker 1 (02:52):
Yeah, you can understand that.
Speaker 2 (02:54):
Yeah.
Speaker 1 (02:54):
So what are the gold standard countries for antibartic prescriptions
and how might we do a better job of emulating
their processes?
Speaker 2 (03:04):
The gold standard countries are the Netherlands, Sweden and some
of the other scan all much pretty much the other
Scandinavian countries, right, and what.
Speaker 1 (03:12):
Do they do well that we don't?
Speaker 2 (03:15):
Well, they don't. We have a big surge and antibiotic
prescribing through the autumn and winter and early spring months
when the viruses are spreading around a bit more because
we're more cramped up inside and they don't have a
big surge. Then they don't run a mark on giving
people antibiotics, you know during those months when people are
getting cops and colds, et cetera. Right, but they start
(03:36):
off with a lower baseline as well. Now we are
not the same as the Netherlands or Sweden. We have
a different population than them. We have more people, you know,
in relative poverty, and we have Marian passive people who
have a particular issue with getting rheumatic fever and some
other higher rate of all sorts of other infections as well.
(03:57):
So we will never get down to the same level
as them, but we could get closer to them without
having a deterioration in the health of the people of
New Zealand.
Speaker 1 (04:07):
So talk to us about how you understand the goals
for reducing antibodic prescriptions are going to work. Do you
understand how that's going to function?
Speaker 2 (04:16):
Yeah, I think if the Ministry of Health and or
the Royal College of General Practitioners said, we think that
a reduction each year of about five percent in the
rate of antibotic prescribing across the whole country would be
a good thing for a number of years. Then I
think GPS would respond to that encouragement, and I think
(04:37):
the general public would hear it and think, h yeah,
well we should be doing what they're saying. And I
won't put my GP under pressure. And maybe when I've
got a cold, I'll just stay at home because I
can look after myself perfectly well without getting given to
the doctor and expecting maybe some antibiotics.
Speaker 1 (04:52):
As someone who's got a lot of expertise in the
space professor, what do you think about as being a
worst case pussibility in the near future. When it comes
to antibiotic resistance, it is.
Speaker 2 (05:05):
A gradual thing. It's like, you know, pollution of rivers
and lakes with too much fertilizer. This is something the same.
It's pollution of the organisms or you know, a change
in the microbiome the families of bacteria that live in
us as a result of exposure to all the antibotics,
and it changes slowly, imperceptibly. That's why we tend to
forget about it. But it is changing. And what happens
(05:29):
is that eventually, and it's already happening to a very
small degree, but it's more overseas in some of the
countries that use even more antibotics than us. Is that
you see patients with bacterial infections and there's three or
four antibiotics that would have worked well against that bacterium
in the past, and there's none now that work against
that particular bacterium that that patient's got, and they end
(05:50):
up dying of the infection, or they end up having
to have the infected foot, for instance, cut off, because
you can't beat the infection with any antibiotics and so
you've just got to cut the foot off. So yeah,
those are those are the worst case scenarios that we
see increasing numbers of people with infections that can't be
treated and that cause catastrophe, and that will happen unfortunately
(06:15):
to the populations in New Zealand who have the highest
rates of infections and have the highest amount of anybodic treatment.
And that's going to be the relatively you know, underprivileged
people in our society and particularly Marian Pacific people. It
will be a terrible thing if we allow it to happen.
Speaker 1 (06:33):
Thank you so much for your time, We really appreciate it.
That is Professor Mark Thomas For more from Hither duplessy
Alan Drive, listen live to news talks it'd be from
four pm weekdays, or follow the podcast on iHeartRadio
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