Pharmaceutical Society of Australia
The Pharmaceutical Society of Australia (PSA) is the peak national professional pharmacy organisation and represents Australia’s 30,000 pharmacists working in all sectors and locations. PSA’s core functions include: providing continuing professional development, education and practice support; developing and advocating standards and guidelines; and representing pharmacists’ role as frontline health professionals.
Do not dispense a repeat prescription for an antibiotic without first clarifying clinical appropriateness.
Inappropriate use of antibiotics could result in infection progression, leading to increased patient morbidity and mortality, as well as contributing to antibiotic resistance. In some chronic conditions, such as COPD, repeated antibiotics form part of a management plan. However, in other cases patients commonly request dispensing of repeat antibiotic prescriptions without consultation with their treating doctor, and sometimes well after the original prescription was written. If a repeat prescription for an antibiotic is requested to be dispensed, consider the clinical appropriateness of the request.
- Australian Commission on Safety and Quality in Health Care (ACSQHC) Antimicrobial Stewardship in Australian Health Care. Sydney: ACSQHC 2018
- Zayegh I, Charrois TL, Hughes J et al. Antibiotic repeat prescriptions: are patients not refilling them properly? J Pharm Policy Pract. 2014;7(1):17
- Fredericks I, Hollingworth S, Pudmenzky A, et al. ‘Repeat’ prescriptions and antibiotic resistance: findings from Australian community pharmacy. Int J Pharm Pract. 2017;25(1):50-58
- Essack S, Bell J, Shephard A. Community pharmacists- Leaders for antibiotic stewardship in respiratory tract infection. Journal of Clinical Pharmacy and Therapeutics. 2018 Apr 1;43(2):302-7
A working party of members of the Pharmaceutical Society of Australia (PSA) was established. Members of the State and Territory Branch Committees were invited to contribute suggested recommendations. Over 40 recommendations were submitted. The working party grouped the recommendations into themes, eliminated ones that were out of scope, reduced the list to twelve and refined the wording. All PSA members were sent an online survey to rank the proposed recommendations, indicate how likely they would be to implement the recommendations in practice, and suggest additional items for consideration.
Based on the survey responses, six recommendations were shortlisted and supporting evidence gathered. The final list was signed off by the PSA Board in November 2018.
Note: PSA uses Vancouver reference style. Where there are more than three authors, only the first three are listed followed by et al.
Do not initiate medications to treat symptoms, adverse events, or side effects (unless in an emergency) without determining if an existing therapy or lack of adherence is the cause, and whether a dosage reduction, discontinuation of a medication, or another treatment is warranted.
- 2 Do not promote or provide homeopathic products as there is no reliable evidence of efficacy. Where patients choose to access homeopathic treatments, health professionals should discuss the lack of benefit with patients.
- 3 Do not dispense a repeat prescription for an antibiotic without first clarifying clinical appropriateness.
Do not prescribe medications for patients on five or more medications, or continue medications indefinitely, without a comprehensive review of their existing medications, including over-the-counter medications and dietary supplements, to determine whether any of the medications or supplements should or can be reduced or discontinued.
- 5 Do not continue benzodiazepines, other sedative hypnotics or antipsychotics in older adults for insomnia, agitation or delirium for more than three months without review.
- 6 Do not recommend complementary medicines or therapies unless there is credible evidence of efficacy and the benefit of use outweighs the risk.