S. Park , K. Thursky , L. Zosky-Shiller , R. James , R. Cheah , L. Hall , C. Ierano
{"title":"澳大利亚医院皮肤和软组织管理中抗菌药物处方的质量：全国抗菌药物处方调查数据分析。","authors":"S. Park , K. Thursky , L. Zosky-Shiller , R. James , R. Cheah , L. Hall , C. Ierano","doi":"10.1016/j.jhin.2024.06.016","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Skin and soft tissue infections (SSTIs) are among the most common indications for antimicrobial prescribing in hospitals. Inappropriate antimicrobial use can lead to increased morbidity, unnecessary hospital re-admission and increased antimicrobial resistance. This study aimed to assess the quality of antimicrobial prescribing practices in SSTI management within Australian hospitals to provide guidance for future practice.</p></div><div><h3>Methods</h3><p>A retrospective analysis was conducted with data from the National Antimicrobial Prescribing Survey (NAPS). SSTI prescribing data from Hospital NAPS (2013–2022) and surgical site infection data from Surgical NAPS (2016–2022) datasets were analysed. Variables assessed included guideline compliance, appropriateness as per the structured NAPS algorithm, and reasons for inappropriateness.</p></div><div><h3>Results</h3><p>From the Hospital NAPS dataset, 40,535 antimicrobial prescriptions for SSTIs were analysed. The most common indication was cellulitis (34.1%, <em>N</em>=13,822), and the most prescribed antimicrobial was flucloxacillin (18.8%, <em>N</em>=7,638). SSTI indications had a lower rate of guideline compliance but a higher rate of appropriateness compared with all other indications for antimicrobial prescriptions (guideline compliance 66.3%, <em>N</em>=21,035 vs 67.4%, <em>N</em>=156,285; appropriateness 75.6%, <em>N</em>=30,639 vs 72.7%, <em>N</em>=209,383). The most common reason for inappropriateness was incorrect dose or frequency (29.3%, <em>N</em>=2367). From the Surgical NAPS dataset, 5674 prescriptions for surgical site infections were analysed. Of these, 68.2% (<em>N</em>=3867) were deemed to be appropriate. The most common reason for inappropriateness was incorrect dose or frequency (27.7%, <em>N</em>=350).</p></div><div><h3>Conclusions</h3><p>As SSTIs are a common indication for prescribing an antimicrobial in Australian hospitals, identifying effective antimicrobial stewardship strategies to optimize antimicrobial use for SSTI management is recommended to improve patient outcomes.</p></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"152 ","pages":"Pages 142-149"},"PeriodicalIF":3.9000,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0195670124002469/pdfft?md5=6ff07825e9c93017bf829ca130959a54&pid=1-s2.0-S0195670124002469-main.pdf","citationCount":"0","resultStr":"{\"title\":\"The quality of antimicrobial prescribing in skin and soft tissue management in Australian hospitals: an analysis of the National Antimicrobial Prescribing Survey data\",\"authors\":\"S. Park , K. Thursky , L. Zosky-Shiller , R. James , R. Cheah , L. Hall , C. Ierano\",\"doi\":\"10.1016/j.jhin.2024.06.016\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>Skin and soft tissue infections (SSTIs) are among the most common indications for antimicrobial prescribing in hospitals. Inappropriate antimicrobial use can lead to increased morbidity, unnecessary hospital re-admission and increased antimicrobial resistance. This study aimed to assess the quality of antimicrobial prescribing practices in SSTI management within Australian hospitals to provide guidance for future practice.</p></div><div><h3>Methods</h3><p>A retrospective analysis was conducted with data from the National Antimicrobial Prescribing Survey (NAPS). SSTI prescribing data from Hospital NAPS (2013–2022) and surgical site infection data from Surgical NAPS (2016–2022) datasets were analysed. Variables assessed included guideline compliance, appropriateness as per the structured NAPS algorithm, and reasons for inappropriateness.</p></div><div><h3>Results</h3><p>From the Hospital NAPS dataset, 40,535 antimicrobial prescriptions for SSTIs were analysed. The most common indication was cellulitis (34.1%, <em>N</em>=13,822), and the most prescribed antimicrobial was flucloxacillin (18.8%, <em>N</em>=7,638). SSTI indications had a lower rate of guideline compliance but a higher rate of appropriateness compared with all other indications for antimicrobial prescriptions (guideline compliance 66.3%, <em>N</em>=21,035 vs 67.4%, <em>N</em>=156,285; appropriateness 75.6%, <em>N</em>=30,639 vs 72.7%, <em>N</em>=209,383). The most common reason for inappropriateness was incorrect dose or frequency (29.3%, <em>N</em>=2367). From the Surgical NAPS dataset, 5674 prescriptions for surgical site infections were analysed. Of these, 68.2% (<em>N</em>=3867) were deemed to be appropriate. 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The quality of antimicrobial prescribing in skin and soft tissue management in Australian hospitals: an analysis of the National Antimicrobial Prescribing Survey data
Background
Skin and soft tissue infections (SSTIs) are among the most common indications for antimicrobial prescribing in hospitals. Inappropriate antimicrobial use can lead to increased morbidity, unnecessary hospital re-admission and increased antimicrobial resistance. This study aimed to assess the quality of antimicrobial prescribing practices in SSTI management within Australian hospitals to provide guidance for future practice.
Methods
A retrospective analysis was conducted with data from the National Antimicrobial Prescribing Survey (NAPS). SSTI prescribing data from Hospital NAPS (2013–2022) and surgical site infection data from Surgical NAPS (2016–2022) datasets were analysed. Variables assessed included guideline compliance, appropriateness as per the structured NAPS algorithm, and reasons for inappropriateness.
Results
From the Hospital NAPS dataset, 40,535 antimicrobial prescriptions for SSTIs were analysed. The most common indication was cellulitis (34.1%, N=13,822), and the most prescribed antimicrobial was flucloxacillin (18.8%, N=7,638). SSTI indications had a lower rate of guideline compliance but a higher rate of appropriateness compared with all other indications for antimicrobial prescriptions (guideline compliance 66.3%, N=21,035 vs 67.4%, N=156,285; appropriateness 75.6%, N=30,639 vs 72.7%, N=209,383). The most common reason for inappropriateness was incorrect dose or frequency (29.3%, N=2367). From the Surgical NAPS dataset, 5674 prescriptions for surgical site infections were analysed. Of these, 68.2% (N=3867) were deemed to be appropriate. The most common reason for inappropriateness was incorrect dose or frequency (27.7%, N=350).
Conclusions
As SSTIs are a common indication for prescribing an antimicrobial in Australian hospitals, identifying effective antimicrobial stewardship strategies to optimize antimicrobial use for SSTI management is recommended to improve patient outcomes.
期刊介绍：
The Journal of Hospital Infection is the editorially independent scientific publication of the Healthcare Infection Society. The aim of the Journal is to publish high quality research and information relating to infection prevention and control that is relevant to an international audience.
The Journal welcomes submissions that relate to all aspects of infection prevention and control in healthcare settings. This includes submissions that:
provide new insight into the epidemiology, surveillance, or prevention and control of healthcare-associated infections and antimicrobial resistance in healthcare settings;
provide new insight into cleaning, disinfection and decontamination;
provide new insight into the design of healthcare premises;
describe novel aspects of outbreaks of infection;
throw light on techniques for effective antimicrobial stewardship;
describe novel techniques (laboratory-based or point of care) for the detection of infection or antimicrobial resistance in the healthcare setting, particularly if these can be used to facilitate infection prevention and control;
improve understanding of the motivations of safe healthcare behaviour, or describe techniques for achieving behavioural and cultural change;
improve understanding of the use of IT systems in infection surveillance and prevention and control.
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