Antimicrobial use in Tasmanian rural hospitals

Fiona Wilson 1, Tara Anderson 1

Public Health Services, Department of Health and Human Services, Tasmania, Hobart, TAS, Australia


Introduction: During 2014, Tasmanian Infection Prevention and Control (TIPCU) in conjunction with the Tasmanian Antimicrobial Stewardship Network (TASNET) developed and piloted an antimicrobial surveillance module for rural hospitals. This was used in 2015 in all 13 Tasmanian rural hospitals to assess antimicrobial use.

Methods: During August 2015, data were collected by nursing staff for all acute care inpatients within rural hospitals who were prescribed antimicrobial treatment. Information collected included rationale for treatment, drug name, dosage, duration of therapy and microbiological testing. Appropriateness of therapy was assessed against the Therapeutic Guidelines: Antibiotic v15 2014. Where possible, results were compared with the 2014 National Antimicrobial Prescribing Survey (NAPS).

Results: There were 216 assessable antimicrobial prescriptions for 38 different antimicrobials for 121 patient admissions. Overall antimicrobial burden was calculated as 27.5 antimicrobial exposure days/100 patient days. The most common indication for use was respiratory tract infections (44%). 21% of patients had a microbiological specimen collected. When considering all elements of prescribing, 51% of prescriptions were deemed appropriate. When antimicrobial choice alone was assessed, 68% of prescriptions were appropriate. The most common indication cited for ‘inappropriate’ prescriptions was respiratory tract infection (68%).

Conclusions: 51% of antimicrobial prescriptions were deemed appropriate when compared with the NAPS 2014 result of 73.7%. Respiratory tract infection was the most common indication for antimicrobial prescribing and was also the most common indication for inappropriate prescribing. Future work includes developing tools for rural hospitals and general practice (GP) prescribers to assist in appropriate antimicrobial prescribing focusing on respiratory tract infections.

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