AI Article Synopsis
- The study aimed to analyze the patterns of prophylactic antimicrobial prescribing in Australian residential aged-care facilities, highlighting the risks of inappropriate use leading to antimicrobial resistance.
- Data from the Aged Care National Antimicrobial Prescribing Survey revealed that 3.7% of residents were prescribed prophylactic antimicrobials, with a significant portion (27.1%) of all prescribed antimicrobials falling into this category, primarily targeting urinary tract issues.
- Findings indicated a need for better documentation and antimicrobial stewardship strategies to enhance the appropriateness of prophylactic prescribing, particularly in reducing prolonged use and improving monitoring practices.
Article Abstract
Background And Objective: Inappropriate antimicrobial use can lead to adverse consequences, including antimicrobial resistance. The objective of our study was to describe patterns of prophylactic antimicrobial prescribing in Australian residential aged-care facilities and thereby provide insight into antimicrobial stewardship strategies that might be required.
Methods: Annual point prevalence data submitted by participating residential aged-care facilities as part of the Aged Care National Antimicrobial Prescribing Survey between 2016 and 2020 were extracted. All antimicrobials except anti-virals were counted; methenamine hippurate was classified as an antibacterial agent.
Results: The overall prevalence of residents prescribed one or more prophylactic antimicrobial on the survey day was 3.7% (n = 4643, 95% confidence interval 3.6-3.8). Of all prescribed antimicrobials (n = 15,831), 27.1% (n = 4871) were for prophylactic use. Of these prophylactic antimicrobials, 87.8% were anti-bacterials and 11.4% antifungals; most frequently, cefalexin (28.7%), methenamine hippurate (20.1%) and clotrimazole (8.8%). When compared with prescribing of all antimicrobial agents, prophylactic antimicrobials were less commonly prescribed for pro re nata administration (7.0% vs 20.3%) and more commonly prescribed greater than 6 months (52.9% vs 34.1%). The indication and review or stop date was less frequently documented (67.5% vs 73.8% and 20.9% vs 40.7%, respectively). The most common body system for which a prophylactic antimicrobial was prescribed was the urinary tract (54.3%). Of all urinary tract indications (n = 2575), about two thirds (n = 1681, 65.3%) were for cystitis and 10.6% were for asymptomatic bacteriuria.
Conclusions: Our results clearly identified immediate antimicrobial stewardship strategies that aim to improve prophylactic antimicrobial prescribing in Australian residential-aged care facilities are required.
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Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9712891 | PMC |
| http://dx.doi.org/10.1007/s40801-022-00323-5 | DOI Listing |
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