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Antimicrobial prescribing snapshot: how aged care homes are faring

Almost one in 10 aged care residents are prescribed an antimicrobial in Australia and, in many cases, details of these prescriptions are not being documented, a national survey has found.

The aged care National Antimicrobial Prescribing Survey (acNAPS) held that the reason for the antimicrobial prescription and review- or stop-date was not documented for 22.1 per cent and 49.3 per cent of antimicrobials prescribed, respectively.

One-fifth of antimicrobials had been administered for longer than six months.

The annual audit of the prevalence of infections and antimicrobial prescribing practises in Australian aged care homes aimed to help providers identify infections and look for opportunities to improve use.

The preliminary results of the survey, conducted between June and September 2017, also revealed a high rate (33.2 per cent) of prescribing for residents who did not meet objective clinical criteria for infection in the week prior to starting antibiotics.

About one-third (29.5 per cent) of antimicrobial prescriptions were for topical use. Skin or soft tissue (31.7 per cent), urinary tract (26.7 per cent), and respiratory tract (20.8 per cent) infections were the three most common indications for prescribing antimicrobials.

This year, the acNAPS team reviewed the medication charts of 12,344 permanent, respite or transitional care residents from 293 homes.

Professor Karin Thursky, director of the National Centre for Antimicrobial Stewardship, said monitoring the quality of antimicrobial use in aged care homes is especially important as elderly residents are vulnerable to infections and, therefore, more likely to be receiving antimicrobial therapy.

“This type of review enables participating homes to reflect on opportunities to improve the safety and quality of antimicrobial use. Improved documentation, and careful review of the ongoing need for prolonged therapies, are possible target issues.

“We strongly recommend that all Australian aged care homes and multi-purpose services participate in the acNAPS in 2018 as part of their quality improvement activities,” Thursky said.

The acNAPS was first piloted in 2015. The report for that year and for 2016 can be accessed here and here.

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