Over-used and underdocumented
THE use of antimicrobials is excessive in Australian aged care homes and documentation around their use is incomplete, according to a new report from the 2016 Aged Care National Antimicrobial Prescribing Survey (acNAPS) published by the Australian Commission on Safety and Quality in Health Care.
The survey identified a number of issues of particular concern:
1. The use of antimicrobials in unconfirmed infection cases
2. More than two-thirds (67.2%) of prescriptions were for residents who did not have signs or symptoms of infection
3. Almost onequarter (23%) of antimicrobials had been administered for longer than six months
4. More than one-quarter (26.9%) of prescriptions were for topical preparation when most minor skin infections are selflimiting and resolve without the use of an antibiotic with standard skin hygiene care - topical antibiotics are only appropriate for patients with minor, localised areas of impetigo
5. The antimicrobial start date was unknown for 3.2% of antimicrobials administered, while the indication was not documented in 22.1% of cases and a review or stop date was not specified for 49.9% of the antimicrobials administered.
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