For community-based health services

Community-based health services play an essential role in tackling antibiotic resistance, so we can keep antibiotics working.

• Antibiotic resistance is happening now in New Zealand and around the world. It can affect anyone, of any age, in any country.
• Overuse of antibiotics is the biggest driver of antibiotic resistance.
• The level of consumption of antibiotics in New Zealand is high compared with many other countries – up to 95 percent of antibiotics are dispensed in the community.
• In New Zealand, community-based consumption of antibiotics is estimated to have increased by up to 49 percent between 2006 and 2014.
• Almost every child in New Zealand has been exposed to antibiotics by the time they turn five.
• About half of the people who visited their GP in 2017 were dispensed at least one systemic antibiotic.
• Māori and Pacific peoples are between two and four times more likely to be admitted to hospital for treatment of an infection than other New Zealanders. This means that Māori and Pacific peoples will be disproportionately impacted by worse health outcomes due to antibiotic resistance.
• Making sure antibiotics are only prescribed when needed will reduce antibiotic use in New Zealand and help us to keep antibiotics working.

• Talk to patients about the importance of appropriate antibiotic use and the dangers of antibiotic resistance. (See For consumers and Together we can keep antibiotics working.)
• Help patients understand when and when not to use antibiotics and provide advice about other ways to manage symptoms. (See For consumers, Choosing Wisely and BPAC and Goodfellow Unit resources.)
• When a doctor has not prescribed antibiotics, provide reassurance, address concerns and provide advice about other ways to manage symptoms.
• Talk to patients about how to prevent infections and their spread – including vaccination, good hand hygiene, safe sex and proper food handling.
• Ask patients to return unused antibiotics to the pharmacy to ensure they are disposed of correctly. (See Amnesty information)
• Properly dispose of unused and expired antibiotics to reduce the chance of them entering the environment. (See Amnesty information)
• Support multi-disciplinary community antimicrobial stewardship programmes with your technical expertise (eg, in aged residential care).
• Use hand hygiene to prevent the spread of infections. (See HQSC hand hygiene resources.)

• Prescribe in accordance with antimicrobial treatment guidelines, and where possible use diagnostics to inform treatment decisions. (See Antimicrobial prescribing guidance and antibiograms)
• Prescribe narrow-spectrum rather than broad-spectrum antibiotics whenever you can.
• Check out the recommendations for using or avoiding antibiotics at Choosing Wisely. (See Choosing Wisely antibiotic messages)
• Talk to your patients about the importance of using antibiotics as directed and the dangers of antibiotic resistance. (See Together we can keep antibiotics working and For consumers.)
• Give your patients advice on how to relieve symptoms of viral infections like a cold or flu, and explain that antibiotics are not effective against viruses. (See BPAC and Goodfellow Unit resources and Choosing Wisely)
• Talk to patients about how to prevent infections and their spread – including making sure they are vaccinated, good hand hygiene, safer sex and proper food handling.
• Ask patients to return any unused antibiotics they have to their pharmacy so they are disposed of correctly and don’t enter the environment. (See Amnesty information.)
• Use hand hygiene to prevent the spread of infections. (See HQSC hand hygiene resources)

• Use hand hygiene to prevent the spread of infections. (See HQSC hand hygiene resources.)
• Talk to patients about how to prevent infections and their spread – including making sure they are vaccinated, good hand hygiene, safer sex and proper food handling.
• Talk to your patients and other health professionals about the importance of appropriate antibiotic use and the dangers of antibiotic resistance. (See For consumers and Together we can keep antibiotics working)
• Give your patients advice on how to relieve symptoms of viral infections like a cold or flu, and explain that antibiotics are not effective against viruses. (See For consumers and Choosing Wisely)
• Ask patients to return any unused antibiotics they have to their pharmacy so they are disposed of correctly and don’t enter the environment. (See Amnesty information)

• Antimicrobial Resistance resources
• New Zealand Antimicrobial Stewardship and Infection Pharmacist Expert Group (NAMSIPEG) 
• He Ako Hiringa:
  
  • 2022 Prescriber, Practice and National Reports (updated quarterly)
  • Webinar – Antimicrobial stewardship: It’s time for collective action
  • Article – Antimicrobial stewardship: Primary care can build on recent gains
  • Reflection activity – EPiC Reflect Antibiotics
    
• BPAC:
  
  • 2018 Prescriber reports
  • Article – Cold season: managing without antibiotics
  • Article – Antibiotics: the future is short
  • Article – Topical antibiotics: keep reducing use
  • Amoxicillin clavulanate Update Report 2015
    
• Goodfellow Unit:
  
  • Webinar – Why are we using antibiotics for placebo?
  • Podcast – Antibiotic prescribing challenges?
  • Gem – Highlights from the BPAC antibiotic guide for antibiotic use
  • Gem – Management tips for the common cold

Atlas of Healthcare Variation on Community Use of Antibiotics
The Health Quality and Safety Commission New Zealand produced the Community use of antibiotics Atlas to highlight regional and demographic variation in community antibiotic use, with the goal of prompting debate and raising questions about why differences exist. They have also produced a PHO analysis. Last updated 2021.

He Ako Hiringa 
He Ako Hiringa publishes three national data stories on key focus areas for primary care: topical antibiotics, amoxicillin + clavulanic acid and antibiotics used for the treatment of urinary tract infections. Data current to last three months and updated quarterly.

ESR surveillance information
The Institute of Environmental Science and Research Limited (ESR) has an extensive surveillance programme on antimicrobial resistance.