​Antibiotic Prescribing Excellence in Primary Care

The Antibiotic Prescribing Excellence in Primary Care (APEX-PC) project is now complete. 

About the project 

The Antibiotic Prescribing Excellence in Primary Care (APEX-PC) project supported 31 Victorian general practices to improve guideline-concordant antibiotic prescribing for 4 common infections, helping Victorians receive safe and effective antibiotics and supporting the prevention of antimicrobial resistance.

The project involved:

• automated prescribing analysis
• practice-level audit and feedback
• accredited educational webinars
• access to Therapeutic Guidelines
• targeted antimicrobial stewardship support.

Background

Antibiotic resistance occurs when an antibiotic previously used to treat or prevent a bacterial infection no longer works. 

This global issue threatens public health by increasing mortality and limiting treatment options.

By limiting the choice of antibiotic treatment options available, antibiotic resistance can lead to increased treatment times, additional costs, and an increase in potential side effects.

Project at a glance

This project:

• spanned from May 2024 to June 2026
• analysed 63,357 antibiotic consultations
• involved 31 Victorian general practices and 96 general practitioners, and a 2-year partnership between Safer Care Victoria, the University of Melbourne and The Royal Melbourne Hospital.

Outcomes

This project improved guideline-concordant prescribing for:

• urinary tract infections improved by 8%.
• dental infections improved by 3.6%.
• tonsillitis/pharyngitis improved by 1.9%.
• otitis media improved by 1.7%.

The proportion of consultations associated with an antibiotic prescription decreased from 8.6% in audit period one to 8.0% in audit period three.

What the project found

Automated audit and feedback was viewed by participants as reliable, feasible and trustworthy, showing potential to support antimicrobial stewardship at scale in general practice.

Regular prescribing data benchmarked against peers, access to Therapeutic Guidelines and education supported improvements in guideline-concordant prescribing.

Aligning the initiative with routine clinical workflows and maintaining strong partnerships supported participation and implementation.

Future programs should target clinicians and practices with the greatest opportunity for improvement while retaining the audit and feedback model.

Summary report