AURA
Antimicrobial Utilisation and Resistance in Australia
Antimicrobial Prescribing Practice in
Australia
Summary Results of the 2013 National Antimicrobial Prescribing Survey
November 2014
The 2013 report provides the results from 151 hospitals across Australia. Participating hospitals take a
snapshot sample of their medication charts and patient records to assess their appropriateness of
antimicrobial prescribing. They are also able to compare their results to other like hospitals.
Earlier reports had indicated that up to 50% of hospital antibiotic prescriptions may be inappropriate.
However, the new NAPS results provide a more contemporary picture about how antimicrobials are
prescribed and applied in Australian hospitals.
The Survey enables healthcare facilities to review how well their antimicrobial prescribing practices
align with best practice, so that they can judge the appropriateness of prescribing, and its compliance
with national or local guidelines.
The results from the NAPS can be used by hospitals as evidence to support the antimicrobial
stewardship criterion of the National Safety and Quality Health Service Standard 3: Preventing and
Controlling Healthcare Associated Infections.
The 2013 results show:
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The appropriateness of the top five most commonly prescribed antimicrobials ranged between
60 and 76 percent. Overall, around thirty percent of prescriptions were deemed to be
inappropriate. Inappropriate use was mainly related to the unnecessary use of broad
spectrum antimicrobials and the incorrect duration of treatment.
Inappropriate prescribing was very common for patients with acute exacerbation of chronic
obstructive pulmonary disease (COPD), 46 percent of prescriptions were noncompliant with
guidelines.
Overall surgical prophylaxis was the highest indication for antimicrobial use. Surgical
prophylaxis was given for more than 24 hours in 41 percent of cases; this falls short of the
best practice of less than 5 percent.
70.9 percent of antibiotic prescriptions had a reason documented in the medical notes.
The most common prescriptions were for the cephalosporin antibiotics: ceftriaxone and
cephazolin.
The Australian Commission on Safety and Quality in Health Care (the Commission) will look to
developing a Clinical Care Standard for antimicrobial use in surgical prophylaxis as it was the highest
indication for antibiotic use. The Commission will also consider appropriate action in regard to Chronic
Obstructive Pulmonary Disease (COPD).
Some of the more important figures from the report are Table 2 and Figure 4, which outline some of the
key findings from 2013 NAPS.
AURA
Antimicrobial Utilisation and Resistance in Australia
Figure 5
Top 20 most common indications
Table 2
Results of key indicators for all contributing hospitals
Key indicator
% of total
prescriptions
% of total assessable
prescriptionsa
Indication documented in medical notes (best practice
>95%)
70.9
–
Surgical prophylaxis given for >24 hours (best practice
<5%)
41.5b
–
Compliance with guidelines: Compliant with Therapeutic
Guidelines: Antibiotic or endorsed local guidelines
59.7
72.2
Compliance with guidelines: Noncompliant
23.0
27.8
Compliance with guidelines: No guideline available
11.0
–
Compliance with guidelines: Not assessable
6.3
–
Appropriateness: Appropriate (optimal + adequate)
70.8
75.6
Appropriateness: Inappropriate (suboptimal + inadequate)
22.9
24.4
Appropriateness: Not assessable
6.3
–
For the full Report, please visit http://www.safetyandquality.gov.au.