Flinders University researchers have secured almost $5 million from the Medical Research Future Fund to address rising antimicrobial resistance (AMR) in remote Northern Territory communities, where diagnostic limitations mean more than a quarter of antibiotic prescriptions in remote primary healthcare clinics are considered unsuitable.
The shortfall is reportedly contributing to resistance rates for common bacteria that are up to four times the national average, with First Nations communities disproportionately affected, according to the research team.
The project, known as “Tackling Antimicrobial Resistance in Remote Australia” (TARRA), is led by Dr Danny Tsai, a research pharmacist at Flinders’ Centre for Remote Health and Alice Springs Hospital, who says the drivers of overprescribing in remote settings are varied and interconnected.
“It’s a complex problem. Over-prescription of antimicrobials is driven by concerns of undertreatment in remote settings, limited access to specialist support, insufficient knowledge of AMR, and geographic isolation from tertiary care centres and constrained healthcare resources,” he says.
“We need to provide more advice to the people prescribing medicines in remote areas — who are often remote area nurses or Aboriginal health practitioners, due to a shortage of doctors in remote Australia.”
The project, which will examine “how to combat increasing antimicrobial resistance to bacterial infections among Indigenous people in remote areas who have limited access to health care”, will build on antimicrobial stewardship models already used in NT hospitals.
Flinders University says that “while clinician-led Antimicrobial Stewardship (AMS) programs in NT hospitals have successfully delivered hospital-based programs that have improved antimicrobial usage and prescribing through multimodal strategic activities such as education activities, antimicrobial prescribing surveillance, and directed clinical support, similar success now needs to be replicated in remote areas that do not have the same health services”.
Dr Tsai is confident the new project will enable a comprehensive AMS program in remote NT locations, with surveillance tools, virtual clinical support, targeted education, culturally appropriate health promotion, and horizon scanning for emerging AMR threats.
Flinders University says “a clinical audit tool will also be customised for remote use, with education and health promotion materials developed to support health providers and improve community health literacy around infections, treatments and AMR”.
“The blueprint laid out by this new research project will serve as an operational framework for other remote primary healthcare settings with similar demographics, providing guidance on AMS implementation and surveillance strategies,” says Flinders University.
Dr Tsai adds: “We need to make this comprehensive, so that all health care workers and patients are equipped with more
information about effective medications.”
