Australia-wide point prevalence survey of antimicrobial prescribing in neonatal units: how much and how good?

Osowicki, Joshua, Gwee, Amanda, Noronha, Jesuina, Britton, Philip N., Isaacs, David, Lai, Tony B., Nourse, Clare, Avent, Minyon, Moriarty, Paul, Francis, Joshua R., Blyth, Christopher C., Cooper, Celia M. and Bryant, Penelope A. (2015) Australia-wide point prevalence survey of antimicrobial prescribing in neonatal units: how much and how good?. Pediatric Infectious Disease Journal, 34 8: e185-e190. doi:10.1097/INF.0000000000000719

Author Osowicki, Joshua
Gwee, Amanda
Noronha, Jesuina
Britton, Philip N.
Isaacs, David
Lai, Tony B.
Nourse, Clare
Avent, Minyon
Moriarty, Paul
Francis, Joshua R.
Blyth, Christopher C.
Cooper, Celia M.
Bryant, Penelope A.
Title Australia-wide point prevalence survey of antimicrobial prescribing in neonatal units: how much and how good?
Journal name Pediatric Infectious Disease Journal   Check publisher's open access policy
ISSN 1532-0987
Publication date 2015-08
Sub-type Article (original research)
DOI 10.1097/INF.0000000000000719
Open Access Status Not yet assessed
Volume 34
Issue 8
Start page e185
End page e190
Total pages 6
Place of publication Philadelphia, PA, United States
Publisher Lippincott Williams and Wilkins
Collection year 2016
Language eng
Formatted abstract
Background:  There is increasing recognition of the threat to neonatal patients from antibiotic resistance. There are limited data on antimicrobial prescribing practices for hospitalized neonates. We aimed to describe antimicrobial use in hospitalized Australian neonatal patients, and to determine its appropriateness.

Methods:  Multicentre single-day hospital-wide point prevalence survey in 2012, in conjunction with the Antimicrobial Resistance and Prescribing in European Children study. The appropriateness of antimicrobial prescriptions was also assessed. All patients admitted at 8 am on the survey day, in 6 neonatal units in tertiary children’s hospitals across 5 states, were included in an analysis of the quantity and quality of all antimicrobial prescriptions.

Results:  The point prevalence survey included 6 neonatal units and 236 patients. Of 109 patients (46%) receiving at least 1 antimicrobial, 66 (61%) were being treated for infection, with sepsis the most common indication. There were 216 antimicrobial prescriptions, 134 (62%) for treatment of infection and 82 (38%) for prophylaxis, mostly oral nystatin. Only 15 prescriptions were for targeted as opposed to empirical treatment. Penicillin and gentamicin were the most commonly prescribed antibiotics, with vancomycin third most common. Half of all treated patients were receiving combination antimicrobial therapy. There was marked variation in vancomycin and gentamicin dosing. Overall, few prescriptions (4%) were deemed inappropriate.

Conclusion:  This is the first Australia-wide point prevalence survey of neonatal antimicrobial prescribing in tertiary children’s hospitals. The findings highlight positive practices and potential targets for quality improvement.
Keyword Antimicrobial stewardship
Early onset sepsis
Late onset sepsis
Neonatal infections
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: UQ Centre for Clinical Research Publications
Official 2016 Collection
School of Medicine Publications
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