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Measuring antimicrobial prescribing quality in outpatient parenteral antimicrobial therapy (OPAT) services: Development and evaluation of a dedicated national antimicrobial prescribing survey

Title: Measuring antimicrobial prescribing quality in outpatient parenteral antimicrobial therapy (OPAT) services: Development and evaluation of a dedicated national antimicrobial prescribing survey
Authors: Friedman, ND; Lim, SM; James, R; Ingram, R; O'Reilly, M; Pollard, JGD; Koning, S; George, C; Rajkhowa, A; Johnson, DF; Buising, KL
Publisher Information: OXFORD UNIV PRESS
Publication Year: 2020
Collection: The University of Melbourne: Digital Repository
Description: BACKGROUND: Antimicrobial stewardship programmes are important in driving safety and quality of antimicrobial prescribing. The National Antimicrobial Prescribing Survey (NAPS) is a point-prevalence audit of inpatient antimicrobial prescribing in Australian hospitals. OBJECTIVES: To design and adapt the NAPS tool for use in the outpatient parenteral antimicrobial therapy (OPAT) and hospital-in-the-home (HITH) setting. METHODS: An inter-disciplinary working group with expertise in OPAT and HITH services was established to adapt the NAPS template for use in the OPAT setting-called HITH-NAPS. This was initially trialled in 5 HITH services, subsequently adapted following participant feedback, then offered nationally to 50 services in 2017. RESULTS: There were 1154 prescriptions for 715 patients audited via the HITH-NAPS. The most common antimicrobials prescribed were cefazolin (22%), flucloxacillin (12%), piperacillin/tazobactam (10%) and ceftriaxone (10%). The most common infections treated were cellulitis (30%) and respiratory tract infections (14%). Eighty-seven percent of prescriptions were assessed as appropriate, 11% inappropriate and 2% not assessable. Prolonged durations of antimicrobials and unnecessarily broad-spectrum antibiotics were used in 9% of prescriptions. CONCLUSIONS: The HITH-NAPS pilot project revealed that auditing of this type is feasible in HITH. It showed that antibiotic use in these HITH services was generally appropriate, but there are some areas for improvement. A national OPAT/HITH-NAPS can facilitate benchmarking between services, identify potentially inappropriate prescribing and help guide quality improvement.
Document Type: article in journal/newspaper
Language: English
ISSN: 2632-1823
Relation: NHMRC/1013746; pii: dlaa058; Friedman, N. D., Lim, S. M., James, R., Ingram, R., O'Reilly, M., Pollard, J. G. D., Koning, S., George, C., Rajkhowa, A., Johnson, D. F. & Buising, K. L. (2020). Measuring antimicrobial prescribing quality in outpatient parenteral antimicrobial therapy (OPAT) services: Development and evaluation of a dedicated national antimicrobial prescribing survey. Jac Antimicrobial Resistance, 2 (3), https://doi.org/10.1093/jacamr/dlaa058.; https://hdl.handle.net/11343/281115
Availability: https://hdl.handle.net/11343/281115
Rights: https://creativecommons.org/licenses/by/4.0 ; CC BY
Accession Number: edsbas.8E1F8414
Database: BASE