Antibiotic pack sizes don't fit

Scimex: Australian researchers have looked at why Australians are often prescribed not enough to too many antibiotics, and report that packaging size is at fault. They found that in 32 common antibiotic prescribing scenarios, 10 patients had doses left over in surplus and 18 had a shortfall, leaving only four in which the packaging size matched the duration recommended by The Australian Therapeutic Guidelines.

Researchers aimed to determine the potential for a source of surplus antibiotics in the community to come from the mismatch between the recommended duration of antibiotic treatment for common indications in primary care and that dictated by default pharmaceutical industry packaging.

Of 32 common antibiotic prescribing scenarios, 10 had doses left over in surplus and 18 had a shortfall, leaving only four in which the packaging size matched the duration recommended by electronic Therapeutic Guidelines. Where there was a shortfall, this was only exactly accommodated by a repeat prescription in two cases.

Mismatch contributes to a shortfall or excess of doses compared to recommended antibiotic treatment protocols and probably exaggerates redundant doses in the community from prescribed antibiotics dispensed and not consumed.

Prescribers need to be aware that the mismatch between antibiotic pack sizes and guideline recommendations for their duration is contributing to antibiotic resistance in the community.