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10 Jun 2016

Frequent, inappropriate use of antibiotics major concern in aged-care facilities

New research has found one in three prescriptions given in Australian residential aged-care facilities were prescribed for six months or more, putting residents at a high risk of antimicrobial resistance.

The 2015 Aged Care National Antimicrobial Prescribing Survey (acNAPS) pilot study investigated the prescribing behaviours and frequency of infections in 186 aged-care facilities around Australia.

acNAPS, conducted by the National Centre for Antimicrobial Stewardship (NCAS) and Victorian Healthcare Associated Infection Surveillance (VICNISS) Coordinating Centre at the Peter Doherty Institute for Infection and Immunity (Doherty Institute – a joint venture of the University of Melbourne and the Royal Melbourne Hospital) and funded by the Australian Commission on Safety and Quality in Health Care, also found one in five prescriptions given in aged-care facilities were inappropriate, meaning residents were prescribed an antibiotic with no clear infection.

In addition, 65 per cent of prescriptions did not have a review or stop date and 30 per cent did not have a specific reason for their use.

University of Melbourne Professor Karin Thursky, NCAS Director and Royal Melbourne Hospital Infectious Diseases Specialist at the Doherty Institute, said there were a number of areas that needed to be addressed in aged-care facilities to prevent resistance, which is now one of the biggest threats to human health.

“In Australia, we need to improve the documentation associated with prescriptions, including justification for their use and a review or stop date. And importantly, infections need to be correctly identified before medications are prescribed,” she said.

“Prescribing is particularly poor in the areas of urinary tract, skin and chest infections.”

Professor Thursky also praised the facilities that contributed to the survey as their participation raised awareness of the importance of combatting antimicrobial resistance in residential aged-care facilities.

“Further collaborations with key aged-care organisations and the Royal Australian College of General Practitioners is required to ensure initiatives to improve prescribing behaviours are sustainable and appropriately tailored for the sector,” she said.

The Australian Commission on Safety and Quality in Health Care encouraged all residential aged-care facilities and multi-purpose services around the country to participate in the 2016 acNAPS.

“This survey provides essential information to improve the effectiveness and safety of antibiotic prescribing for residents in aged care facilities across Australia,” The Commission’s Senior Medical Advisor, Professor John Turnidge said.

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