Now in its fourth year, the annual National Antimicrobial Prescribing Survey (NAPS) provides a valuable monitor of Austalia’s commitment to best practice in Antimicrobial Stewardship. The report of the 2013 survey, released this week, reviewed nearly 13,000 prescriptions for antimicrobials in 151 hospitals.

Almost 60% of prescriptions complied with guidelines, however including “adequate” prescribing expanded orders accepted as appropriate to over 70%.

The most frequently prescribed class were cephalosporins, and ceftriaxone in particular, which was deemed appropriate in 65% of cases. Cephalexin was found to be prescribed appropriately in only half of its orders. (Extrapolation of this statistic into the wider PBS community raises questions about the concordance to best practice of an estimated 24.5 million cephalexin prescriptions dispensed annually in Australia.)

70.9% of the prescriptions had a documented indication, the most common being surgical prophylaxis which were inappropriately prescribed beyond 24 hours in 41.5% of patients. Surgical prophylaxis, along with COPD (chronic obstructive pulmonary disease), was subsequently nominated for the development of Clinical Care Standards by the Australian Commission on Safety and Quality in Health Care, while also being extensively revised and extended in the 15th version of theTherapeutic Guidelines: Antibiotic that was released this week.

Inappropriate prescribing was most often due to using broad spectrum antimicrobials, which increases the risk of developing antimicrobial resistence.

HPS Pharmacies offers support to clients who wish to join the 390 hospitals enrolled in the 2014 NAP Survey amongst its range of Antimicrobial Stewardship services provided to hospitals and health facilities.

References:

  1. Australian Commission on Safety and Quality in Health Care. Antimicrobial prescribing practice in Australia: results of the 2013 National Antimicrobial Prescribing Survey. Sydney: ACSQHC; 2014.

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