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Published: 13 November, 2020


World Antimicrobial Awareness Week (WAAW) - 18 - 24th November

The theme for this year’s WAAW is “United to preserve antimicrobials”. Details of this global initiative from the World Health Organization are available here (and yes, the week runs from Wednesday to the following Tuesday, that is not a typo!).

WAAW is a timely reminder that antimicrobial stewardship (AMS) is an interprofessional, multidisciplinary responsibility, including patient/consumer education. AMS is a collective set of strategies to improve the appropriate use of antimicrobials and minimise antimicrobial-related harms including resistance and adverse effects. WAAW is an opportunity to reflect on your use of antibiotics and consider practice updates and reviews to apply the principles of AMS.

Make it meaningful: A New Zealand initiative encourages all prescribers to document a meaningful (specific) indication for antimicrobial use within the prescription, e.g. trimethoprim + sulfamethoxazole, 960 mg (two tablets), twice daily, for ten days, for pyelonephritis. Adding the indication justifies the reason for using an antibiotic and selecting this particular antibiotic and duration of treatment. For resources and further information about this collaborative DHB initiative, click here.

Local resources for antibiotic awareness including posters and patient education are available from the Ministry of Health website.

Article for reflection "Antibiotics: the future is short", written by bpacnz.

Modified-release nitrofurantoin capsules to be funded from 1 March, 2020

PHARMAC has announced a decision to fund a new modified-release formulation of nitrofurantoin for the treatment of uncomplicated urinary tract infections. The Macrobid brand of nitrofurantoin modified-release 100 mg capsules will be funded from 1 March, 2021.

Nitrofurantoin is currently recommended as the first-line treatment for symptomatic cystitis in adults. The recommended dose is 50 mg, four-times daily for five days, or for seven days in males or pregnant women. When available, an alternative regimen of 100 mg modified-release capsules, twice daily, would be a suitable treatment. A twice-daily regimen is likely to improve treatment adherence.

As Macrobid has only recently received Medsafe approval, a datasheet is not yet available, but is expected to be listed on the Medsafe website prior to 1 March. The standard-release 50 mg and 100 mg nitrofurantoin tablets will remain available and funded.

Decision on funding of new medicines for type 2 diabetes delayed

In Bulletin 10 we reported that PHARMAC was consulting on a proposal to fund two new medicines for diabetes – a sodium-glucose co-transporter 2 (SGLT2) inhibitor, empagliflozin (with and without metformin) and an injectable glucagon-like peptide 1 (GLP-1) receptor agonist, dulaglutide. It was initially proposed that, if implemented, these medicines could be funded from 1 December, 2020. However, PHARMAC has announced that they require additional time to consider the feedback that was received during the consultation period. Therefore, a decision will not be made in time for the medicines to be available from December. There is no indication when the decision on funding will be made.

Zostavax catch-up to end soon

Zostavax (shingles vaccine) is funded on the National Immunisation Schedule for people aged 65 years. People who turned 65 years before the vaccine was funded on 1 April, 2018, have been eligible for a funded catch-up vaccine. This was due to end in March, 2020, however, the catch-up programme has been extended until 31 December, 2020. This means that people aged between 67 and 80 years who have not yet received Zostavax, can receive a funded vaccine until the end of this year. People who turned 65 years on or after 1 April, 2018, do not have a time limit to receive a funded dose of Zostavax, however, it is recommended to be given as close to age 65 years as possible.

Read further information from the Immunisation Advisory Centre.

Paper of the week: Latest report released on cardiac surgeries in New Zealand

For the past five years, the New Zealand National Cardiac Surgery Clinical Network has been collating data on publicly funded cardiac surgeries performed at five hospitals across the country. The latest national report includes data on demographics, risk factors and outcomes for all 2,625 patients who underwent surgery in 2018. The report contains some very thought-provoking findings and is likely to be of interest to all healthcare professionals who have a role in caring for patients with cardiovascular disease.

This Bulletin is supported by the South Link Education Trust

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