New action plan for antibiotic resistance in the health services
The Antibiotic Centre for Primary Care plays an important role in following up the national strategy to reduce antibiotic use in the population by 30 per cent by 2020.
Researchers at the Antibiotic Centre for Primary Care. Photo: Anbjørg Kolaas
The Norwegian Ministry of Health and Care Services has made NOK 5 million available in the 2016 budget, earmarked for follow-up of the action plan. This has resulted in a significant boost for the Antibiotic Centre for Primary Care, since four of these five million Norwegian kroner go to the Centre.
A threat to public health
Antibiotic-resistant bacteria represent one of the greatest challenges to public health, and will entail dramatic consequences if these bacteria spread. We will then revert to an era when people will once again die from what are viewed today as trivial illnesses.
Without the availability of effective antibiotics, we may be unable to use current advanced methods of medical treatment.
The Antibiotic Centre’s responsibilities
- Peer coaching and review of personal antibiotic prescribing practices at group level. This means that GPs and accident and emergency department doctors will be offered participation in groups with peer review of their own antibiotic prescribing practice. They will review and receive feedback on the amount of antibiotics they prescribe for patients, and be given updated information on recommended treatment.
- Group-based further training for nursing home doctors
- Support the Directorate of Health by revising, updating and further developing the "National Guidelines for the Use of Antibiotics in Primary Care " and by developing/elaborating the guidelines for nursing homes and dentists. An effort must also be made to make the guidelines even more readily available for primary care (GPs, nursing home doctors, dentists and accident and emergency department doctors).
Measures to reduce antibiotic consumption
During 2017, electronic patient records will be linked to the National Guidelines for the Use of Antibiotics in Primary Care to render it easier for doctors to follow the national recommendations for antibiotic treatment.
The therapeutic recommendation in the guidelines is based on documented effect and side effects, and describes who should receive what treatment, for what conditions. The Centre shall also act as a mentor for extended piloting of the KUPP project (the Norwegian version of the ‘academic detailing’ method of training).
Another measure outlined in the action plan is to reduce the current validity period of one year for antibiotic prescriptions, in order to avoid erroneous and unwarranted ‘self-medicating’ at a later date, by making use of unused prescriptions.
The Centre also aims to reduce the package size of antibiotics so that these are more in line with the recommended dose of the course of medication, in order to prevent the use of unused tablets on later occasions. Diagnostic codes will also be introduced on all antibiotic prescriptions.
Measures aimed at the general public are also essential in order to increase the level of knowledge and competence in the use of antibiotics among the population at large. Extended and increased use of vaccines and revaccination could also reduce the prevalence of infections and resulting contagion and antibiotic use.
The measures implemented by the Centre as well as the other measures described will together reduce antibiotic consumption.