Antibiotic prescribing in surgery: A clinically and socially complex problem in Australia

Courtney Ierano; Arjun Rajkhowa; Trisha Peel; Caroline Marshall; Darshini Ayton; Karin Thursky

doi:10.1016/j.idh.2020.04.004

Antibiotic prescribing in surgery: A clinically and socially complex problem in Australia

Infect Dis Health. 2020 Nov;25(4):309-313. doi: 10.1016/j.idh.2020.04.004. Epub 2020 May 20.

Authors

Courtney Ierano¹, Arjun Rajkhowa², Trisha Peel³, Caroline Marshall⁴, Darshini Ayton⁵, Karin Thursky⁶

Affiliations

¹ National Health and Medical Research Council Centre of Research Excellence: National Centre for Antimicrobial Stewardship (NCAS), Peter Doherty Research Institute for Infection and Immunity Melbourne, VIC, Australia; University of Melbourne, Faculty of Medicine, Dentistry and Health Sciences, Department of Medicine, Royal Melbourne Hospital, Parkville, VIC, Australia. Electronic address: cierano@student.unimelb.edu.au.
² National Health and Medical Research Council Centre of Research Excellence: National Centre for Antimicrobial Stewardship (NCAS), Peter Doherty Research Institute for Infection and Immunity Melbourne, VIC, Australia; University of Melbourne, Faculty of Medicine, Dentistry and Health Sciences, Department of Medicine, Royal Melbourne Hospital, Parkville, VIC, Australia.
³ National Health and Medical Research Council Centre of Research Excellence: National Centre for Antimicrobial Stewardship (NCAS), Peter Doherty Research Institute for Infection and Immunity Melbourne, VIC, Australia; Department of Infectious Diseases, Alfred Health/Monash University, Melbourne, VIC, Australia.
⁴ National Health and Medical Research Council Centre of Research Excellence: National Centre for Antimicrobial Stewardship (NCAS), Peter Doherty Research Institute for Infection and Immunity Melbourne, VIC, Australia; University of Melbourne, Faculty of Medicine, Dentistry and Health Sciences, Department of Medicine, Royal Melbourne Hospital, Parkville, VIC, Australia; Infection Prevention and Surveillance Service, Royal Melbourne Hospital, Parkville, VIC, Australia; Victorian Infectious Diseases Service (VIDS), Royal Melbourne Hospital, Parkville, VIC, Australia.
⁵ Monash University, Department of Epidemiology and Preventive Medicine, 553 St Kilda Road, Melbourne, VIC, Australia.
⁶ National Health and Medical Research Council Centre of Research Excellence: National Centre for Antimicrobial Stewardship (NCAS), Peter Doherty Research Institute for Infection and Immunity Melbourne, VIC, Australia; University of Melbourne, Faculty of Medicine, Dentistry and Health Sciences, Department of Medicine, Royal Melbourne Hospital, Parkville, VIC, Australia; Department of Infectious Diseases, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.

PMID: 32444345
DOI: 10.1016/j.idh.2020.04.004

Abstract

Surgical prophylaxis is a common indication for antimicrobial use in Australian hospitals with demonstrated poor rates of appropriateness. Ongoing analysis of the Surgical National Antimicrobial Prescribing Survey and exploration of influences on antimicrobial prescribing decisions can help identify clinical and behavioural issues that contribute to problematic antimicrobial use. Triangulation of quantitative and qualitiatve data supports the development of surgical antimicrobial stewardship, i.e., quality improvement initiatives for the optimisation of surgical antimicrobial prophylaxis. Such initiatives should be developed and implemented at both local and national levels to ensure that they remain effective and sustainable.

Keywords: Antimicrobial; Antimicrobial stewardship; Behaviour change; Infection control; Infection prevention; Surgical antimicrobial prophylaxis.

MeSH terms

Anti-Infective Agents / administration & dosage
Anti-Infective Agents / therapeutic use*
Antimicrobial Stewardship
Australia
Humans
Inappropriate Prescribing
Practice Patterns, Physicians'*
Quality Improvement
Surgical Wound Infection / prevention & control*

Substances

Anti-Infective Agents