'Repeat' prescriptions and antibiotic resistance: findings from Australian community pharmacy.
OBJECTIVE
Australians are among the highest users of antibiotics in the developed world. The primary aim was to determine the 'age' of antibiotic prescriptions at the time of dispensing as a possible contributor to antibiotic misuse and ultimately, resistance. The secondary aim was to test customised software to permit extraction and de-identification of dispensing records for analysis.


METHODS
Data were extracted and de-identified from computerised dispensing systems in three community pharmacies in Brisbane, Australia, according to a strict ethical protocol. All prescription records dispensed between 1 January 2010 and 31 December 2012 were merged to form a complete dataset of 1 158 871 de-identified dispensing records which were analysed using Microsoft Excel®. A retrospective drug utilisation study was conducted on a subset of 100 573 antibiotic records. In a substudy conducted at a single pharmacy site, all antibiotic records dispensed over a 4-month (winter) period were examined to determine the age of prescriptions.


RESULTS
Nearly one in ten antibiotics (9.0%) was dispensed from prescriptions that were more than a month old, and over one in five (22.1%) were dispensed from a repeat prescription.


CONCLUSIONS
Health system factors may contribute to inappropriate antibiotic use in Australia, including availability and validity of repeat antibiotic prescriptions. Government health departments, prescribers, pharmacists, other health professionals and consumers have to share the responsibility of ensuring that antibiotics are used appropriately.
School of Pharmacy, The University of Queensland, Woolloongabba, QLD, Australia.
Ian
I
Fredericks
School of Pharmacy, The University of Queensland, Woolloongabba, QLD, Australia.
Samantha
S
Hollingworth
School of Information Technology and Electrical Engineering, The University of Queensland, St Lucia, QLD, Australia.
Alex
A
Pudmenzky
School of Pharmacy, The University of Queensland, Woolloongabba, QLD, Australia.
Laurence
L
Rossato
Pharmacy, School of Medicine & Dentistry, James Cook University, Townsville, QLD, Australia.
Therése
T
Kairuz
D001315:Australia; D003157:Community Pharmacy Services / Q000706:statistics & numerical data*; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D004352:Drug Resistance, Microbial; D004363:Drug Utilization / Q000706:statistics & numerical data*; D006801:Humans; D012189:Retrospective Studies; D013997:Time Factors
Australia; antibiotics; prescription; resistance; respiratory tract infection