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Our objective was to compare patterns of dental antibiotic prescribing in Australia, England, and North America (United States and British Columbia, Canada).
Population-level analysis of antibiotic prescription.
Outpatient prescribing by dentists in 2017.
Patients receiving an antibiotic dispensed by an outpatient pharmacy.
Prescription-based rates adjusted by population were compared overall and by antibiotic class. Contingency tables assessed differences in the proportion of antibiotic class by country.
In 2017, dentists in the United States had the highest antibiotic prescribing rate per 1,000 population and Australia had the lowest rate. The penicillin class, particularly amoxicillin, was the most frequently prescribed for all countries. The second most common agents prescribed were clindamycin in the United States and British Columbia (Canada) and metronidazole in Australia and England. Broad-spectrum agents, amoxicillin-clavulanic acid, and azithromycin were the highest in Australia and the United States, respectively.
Extreme differences exist in antibiotics prescribed by dentists in Australia, England, the United States, and British Columbia. The United States had twice the antibiotic prescription rate of Australia and the most frequently prescribed antibiotic in the US was clindamycin. Significant opportunities exist for the global dental community to update their prescribing behavior relating to second-line agents for penicillin allergic patients and to contribute to international efforts addressing antibiotic resistance. Patient safety improvements will result from optimizing dental antibiotic prescribing, especially for antibiotics associated with resistance (broad-spectrum agents) or C. difficile (clindamycin). Dental antibiotic stewardship programs are urgently needed worldwide.
Andrew Harding, in his excursus on ‘legal transplantation’, observed: ‘[W]e do live in a world of legal connectivity in which we share common problems which can only be addressed by a limited range of solutions which are unlikely not to have been tried before’. This prescient remark is apt in the context of the growing importance of the proportionality concept in the Australian public law arena. The proportionality concept attained particular prominence when the High Court of Australia found a freedom of political communication impliedly embedded in the Constitution. It was inevitable that with the establishment of such an implied fundamental constitutional guarantee, the High Court had to craft a principle to enable the saving or invalidation of legislation claimed to be in violation of the implied freedom.
This chapter examines the extent to which there is, or may be, accountability with regard to the exercise of such powers as a result of the administrative mechanism of judicial review. It examines the way in which judges, in exercising restraint, may hinder the bringing of successful review applications with regard to exercises of emergency powers. It also focuses on express attempts by the legislature to limit the availability of judicial review, in the form of privative clauses, and the possible impact of those attempts on the review of emergency powers. Doctrines relating to ‘justiciability’, ‘act of state, ‘deference’, and procedural fairness are highlighted.
This chapter examines the power of Australian governments, both federal and state, to address public disorder against a backdrop of recognised constitutional protections for political assembly, especially the judicially established implied freedom of political communication. The laws, statutory and common law, pertaining to unlawful assembly, anti-association legislative measures, sedition, and special public disorder emergency powers are scrutinised.
The chapter focuses on the constitutional and legal frameworks regulating the call-out of the Australian Defence Force in aid of the civil power. This topic has become more prominent as result of the rise of global terrorism. It examines the implications of the Lindt Café siege and the 1978 Sydney Hilton bombing. The constitutional provisions of section 119 are scrutinised to determine the framework under which the military forces are deployed to assist a state against domestic violence. The Defence Act 1903 (Cth) is discussed.
This chapter describes the sorts of emergencies which have been experienced in Australia, including the contemporary war on terrorism.It explores the definitional problems of 'emergency', the dangers of over-reaction to an emergency as exemplified by the experience in some countries. It makes reference to international norms regulating the exercise of emergency powers.
This chapter examines the panoply of special powers frameworks for dealing with civil emergencies, particularly environmental emergencies, chemical, biological, radiological and nuclear emergencies, and public and biosecurity emergencies. It also looks at ad-hoc legislation conferring special powers in respone to a particular situation of emergency.
This chapter discusses two vital legal weapons that were made available to the authorities to deal with dangers posed by terrorists in the wake of the September 11 attacks in the United States and the many bombing tragedies in a number of countries. It provides an account of how preventative detention measures were considered by the courts in Australia and the United Kingdom. Issues relating to the constitutional validity of preventative detention orders and control orders provided by federal legislation are canvassed by reference to the separation of judicial power doctrine. The persona designata doctrine and the incompatibility doctrine as expounded by the High Court are discussed. Particular attention is given to the landmark case of Thomas v. Mowbray, in which the validity of a control order authorised by a federal judge was upheld by the High Court. Attention is focused on the operation of the Kable principle to determine the validity of state legislation authorising preventative detention orders and control orders.
This chapter explores the executive powers of the Australian government that are of particular relevance in emergency contexts. It focuses on the contemporary interpretation of the High Court on the scope of section 61 of the Commonwealth Constitution, which is viewed as the ultimate source of all national executive power in Australia. It discusses the issue of whether the exercise of the executive power to requisition property for war or emergency purposes is subject to a requirement to pay just compensation. The relationship with the prerogative powers and the notion of a bundle of inherent powers arising from the Commonwealth’s status as a national government are explored. It engages in a discussion of recent cases in relation to measures taken to respond to the global financial crisis of 2007.
This chapter engages in an exegesis on the defence power as set out in the Commonwealth (Australian) Constitution. It highlights the settled features of the defence power, its expansion and contraction by reference to the prevailing wartime or peacetime circumstances. It provides a succinct analysis of the decisions of the High Court of Australia that define the parameters of the power. Special attention is given to the Communist Party Case and the significance of the case for the rule of law. The case of Thomas v. Mowbray is analysed for its impact on the jurisprudence pertaining to the defence power. Attention is given to the application of the proportionality principle and the limits of the defence power.
Democratic countries, such as Australia, face the dilemma of preserving public and national security without sacrificing fundamental freedoms. In the context where the rule of law is an underlying assumption of the constitutional framework, Emergency Powers in Australia provides a succinct analysis of the sorts of emergency which have been experienced in Australia and an evaluation of the legal weapons available to the authorities to cope with these emergencies. It analyses the scope of the defence power to determine the constitutionality of federal legislation to deal with wartime crises and the 'war' on terrorism, the extent of the executive power and its relationship to the prerogative, the deployment of the defence forces in aid of the civil power, the statutory frameworks regulating the responses to civil unrest, and natural disasters. The role of the courts when faced with challenges to the invocation of emergency powers is explained and analysed.