Australia-wide point prevalence survey of the use and appropriateness of antimicrobial prescribing for children in hospital

Osowicki, Joshua, Gwee, Amanda, Noronha, Jesuina, Palasanthiran, Pamela, McMullan, Brendan, Britton, Philip N, Isaacs, David, Lai, Tony, Nourse, Clare, Avent, Minyon, Moriarty, Paul, Clark, Julia, Francis, Joshua R, Blyth, Christopher C, Cooper, Celia M and Bryant, Penelope A (2014) Australia-wide point prevalence survey of the use and appropriateness of antimicrobial prescribing for children in hospital. Medical Journal of Australia, 201 11: 657-662. doi:10.5694/mja13.00154

Author Osowicki, Joshua
Gwee, Amanda
Noronha, Jesuina
Palasanthiran, Pamela
McMullan, Brendan
Britton, Philip N
Isaacs, David
Lai, Tony
Nourse, Clare
Avent, Minyon
Moriarty, Paul
Clark, Julia
Francis, Joshua R
Blyth, Christopher C
Cooper, Celia M
Bryant, Penelope A
Title Australia-wide point prevalence survey of the use and appropriateness of antimicrobial prescribing for children in hospital
Journal name Medical Journal of Australia   Check publisher's open access policy
ISSN 0025-729X
Publication date 2014-12
Year available 2014
Sub-type Article (original research)
DOI 10.5694/mja13.00154
Open Access Status
Volume 201
Issue 11
Start page 657
End page 662
Total pages 6
Place of publication Strawberry Hills, Australia
Publisher Australasian Medical Publishing Company
Collection year 2015
Language eng
Formatted abstract
Objectives: To describe antimicrobial use in hospitalised Australian children and to analyse the appropriateness of this antimicrobial use.

Design: Multicentre single-day hospital-wide point prevalence survey, conducted in conjunction with the Antimicrobial Resistance and Prescribing in European Children study.

Setting: Eight children's hospitals across five Australian states, surveyed during late spring and early summer 2012. Patients: Children and adolescents who were inpatients at 8 am on the day of the survey.

Main outcome measures: Quantity and quality of antimicrobial prescribing.

Results: Of 1373 patients, 631 (46%) were prescribed at least one antimicrobial agent, 198 (31%) of whom were <1 year old. The highest antimicrobial prescribing rates were in haematology and oncology wards (76% [95/125]) and paediatric intensive care units (55% [44/80]). Of 1174 antimicrobial prescriptions, 550 (47%) were for community-acquired infections, 175 (15%) were for hospital-acquired infections and 437 (37%) were for prophylaxis. Empirical treatment accounted for 72% of antimicrobial prescriptions for community-acquired infections and 58% for hospital-acquired infections (395 and 102 prescriptions, respectively). A total of 915 prescriptions (78%) were for antibacterials; antifungals and antivirals were predominantly used for prophylaxis. The most commonly prescribed antibacterials were narrow-spectrum penicillins (18% [164 prescriptions]), beta-lactam-beta-lactamase inhibitor combinations (15% [136]) and aminoglycosides (14% [128]). Overall, 957 prescriptions (82%) were deemed appropriate, but this varied between hospitals (range, 66% [74/112] to 95% [165/174]) and specialties (range, 65% [122/187] to 94% [204/217]). Among surgical patients, 65 of 187 antimicrobial prescriptions (35%) were deemed inappropriate, and a common reason for this was excessive prophylaxis duration.

Conclusion: A point prevalence survey is a useful cross-sectional method for quantifying antimicrobial use in paediatric populations. The value is significantly augmented by adding assessment of prescribing quality.
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

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Created: Mon, 23 Feb 2015, 10:12:53 EST by Ms Kate Rowe on behalf of UQ Centre for Clinical Research