Research targets antibiotic inequities

Researchers are investigating how New Zealand can tackle antibiotic resistance without preventing people from getting antibiotics when they need them, thanks to a $300,000 grant from the inaugural Infectious Diseases Research Aotearoa (IDRA) funding round.

Dr Karen Wright (Kāi Tahu), a public health physician and senior lecturer at Te Kupenga Hauora Māori, Waipapa Taumata Rau, University of Auckland, will lead the 12-month programme.

The funding comes as antimicrobial resistance continues to rise worldwide, placing growing pressure on health systems and undermining the effectiveness of common treatments.

 The overuse of antibiotics increases the likelihood that bacteria will become resistant to them, Wright says.

"Having antibiotics means we can treat infections, and often really serious infections, which saves lives. 

The study builds on research that developed Te Whata Kura, New Zealand's national antibiotic guidelines and examined how prescribing decisions can contribute to health inequities.

Māori and Pacific peoples face disproportionately high rates of infection-related hospital admissions, which are more than double those of European and other ethnic groups, Wright says.

"Efforts to reduce unnecessary prescribing must therefore avoid creating additional barriers for those who are experiencing high hospital admission rates."

Acute rheumatic fever rates are particularly concerning. Earlier research found Māori are nearly 10 times more likely to be admitted to hospital with the condition than non-Māori and non-Pacific people, while rates for Pacific peoples are more than 25 times higher, she says.

Serious infections also have a greater impact on children. Death rates from pneumonia, meningitis and sepsis are around three to four times higher for Māori and Pacific children than for non-Māori and non-Pacific children, according to Wright.

The team will develop a framework to help ensure that clinical guidelines support equitable care. Researchers will also work with primary health organisations and clinicians to explore how storytelling can make prescribing data more meaningful and encourage changes in practice.

Most antibiotics are prescribed in primary care, making it a key focus area.

"We're aiming to ensure people receive the right antibiotic at the right time, and don't receive antibiotics when they aren't needed."

The framework will be tested using Te Whata Kura as a case study, while a prescribing data prototype will be developed in collaboration with Primary Health Organisations (PHOs).

"What excites me is the opportunity that these innovations will help to address and eliminate longstanding inequities."

Launched in September, the collaboration draws together experts in infectious diseases, public health, pharmacy, primary care, antimicrobial stewardship and Māori health from across New Zealand.