The future of antibiotics depends on all of us: Therapeutic Guidelines does its bit

herapeutic Guidelines exists to promote best possible patient outcomes. Given the magnitude of the problem of antimicrobial resistance, it needs a community-wide response. In recognition of World Antibiotic Awareness Week (18–24 of November), CEO Dr Leigh-Anne Claase reflects on our efforts to support appropriate prescribing of antibiotics.


Expansion of antibiotic topics

eTG complete covers management of a wide range of infections, from self-limiting infections usually managed in primary care  to severe infections that require treatment in hospital.

In April this year, these topics were republished—extensively revised and expanded. The culmination of over two years’ work, involving 47 clinicians, 6 dedicated editors, and feedback from a vast network of front-line users, it is the largest project we have ever undertaken. The content doubled in size, reflecting not only the addition of new topics, but our focus on clear dosing information and improving advice on treating patients with antibiotic hypersensitivity. New resources were included to support practitioners seeking to reduce inappropriate antimicrobial use, including decision aids and patient handouts, and duration of therapy was reviewed for every indication.


The Primary Care Summary Table

Therapeutic Guidelines is an independent not-for-profit charity, and we rely on the financial support of the healthcare community to fund our work. We recognise our independence has a downside though—that the guidelines are not free for everyone to use. This particularly affects those practicing in primary care, where about 40% of GPs do not have access to eTG complete. For the first time, we decided to develop a summary table of the most common infections in primary care and make it available outside the paywall (it can be downloaded here). We partnered with many key organisations to distribute the table and raise awareness and uptake, including NPS Medicinewise and the RACGP. The response has been terrific—we’re pleased prescribers find it a useful tool to guide day-to-day treatment of infections.


New partnerships to improve access

However, we don’t think the summary table is the perfect solution—we couldn’t fit all the helpful information in eTG complete into one table! Therapeutic Guidelines continues to work with the healthcare community to find ways to fund wider access. For example, two Primary Health Networks (PHNs) now provide access to all of their GPs—Adelaide PHN and Northern Territory PHN. These partnerships are great news for primary care, where we hope we can one day replicate the universal access enjoyed by practitioners in the public hospital system.


All good books come to an end

Important changes to our guideline update process are in development, enabling topics within eTG complete to be updated in response to changes in the evidence in a timely manner. This is particularly important for the infection topics, because antimicrobial resistance is a rapidly evolving problem. As the books could no longer be relied upon to reflect our most up-to-date advice, we made the difficult decision to gradually withdraw from book publishing. The April release of the antibiotic guidelines was the first major update to be published solely in digital format. We miss the pink book, as I’m sure many of our users do, but we hope you’ll agree that the trade-off—bang up-to-date advice—will be worth it.


Improved search functionality

When we upgraded eTG complete in 2015, the search function was designed to deliver granular results. However, we heard loud and clear from our users that this sensitivity sometimes means too many results to be helpful. This is a particular problem for the antibiotic guidelines, which are unusual in that they can have more than one topic on a particular diagnosis (eg UTI and pneumonia). Our digital team has been hard at work on a solution, which I’m thrilled to say is about to be launched. You can find out more information about the upgrades to the search function here.


Podcasts, webinars and social media

We want to be more accessible. We understand it’s not easy to stay abreast of all the changes in eTG complete that are relevant to your practice. To this end, we’ve introduced a number of new ways to communicate with you. We’ve created podcasts with Australian Prescriber (Diabetes, Ulcer and Wound), Purple Pen, and the GP Show. We’ve put on webinars for the Society of Hospital Pharmacists, and run our first ever Active Learning Module at the GP19 conference. We continue to work on our social media presence, and plan to use this in future to keep you informed about rolling topic updates—when they launch next year.

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