Abstract
Aotearoa New Zealand (NZ) has had high rates of community antibiotic dispensing for many years, much of it for patients with self-limiting viral respiratory tract infections, for which antibiotic “treatment” provides no benefit.An unavoidable consequence of the high rate of community antibiotic use in NZ is that the prevalence of antibiotic resistance in common bacterial pathogens is much higher than in other countries where antibiotics are less frequently prescribed for illnesses for which they provide no benefit. Influential healthcare leaders in NZ, such as Te Whatu Ora and the Royal New Zealand College of General Practitioners, should set goals to strongly encourage sustained cumulative reductions in inappropriate antibiotic prescribing. Evidence from other countries shows that large reductions in community antibiotic use can be achieved without adverse consequences. Failure to dramatically reduce inappropriate antibiotic prescribing in NZ will impose a high cost in increased death and disability from untreatable bacterial infections in the coming decades. This cost will inevitably fall hardest on those communities with the highest overall rates of antibiotic use, currently Pacific and Māori whānau.