Skin and soft tissue infections and current antimicrobial prescribing practices in Australian aged care residents
| Autor: | Kirsty Buising, Nabeel Imam, Noleen Bennett, C. S. Chen, Ann L. Bull, Karin A Thursky, Robyn Ingram, Rodney James, Leon J Worth |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
0301 basic medicine
Male medicine.medical_specialty Epidemiology 030106 microbiology Inappropriate Prescribing Skin infection Rate ratio surveillance system 03 medical and health sciences 0302 clinical medicine Internal medicine Medicine Humans 030212 general & internal medicine Aged care Medical prescription Practice Patterns Physicians' Skin Diseases Infectious Aged Aged 80 and over Original Paper Practice patterns business.industry Soft Tissue Infections Australia Soft tissue medicine.disease Antimicrobial antimicrobial drugs Confidence interval skin infections Anti-Bacterial Agents Infectious Diseases Female business |
| Zdroj: | Epidemiology and Infection |
| ISSN: | 1469-4409 0950-2688 |
| Popis: | To determine the burden of skin and soft tissue infections (SSTI), the nature of antimicrobial prescribing and factors contributing to inappropriate prescribing for SSTIs in Australian aged care facilities, SSTI and antimicrobial prescribing data were collected via a standardised national survey. The proportion of residents prescribed ⩾1 antimicrobial for presumed SSTI and the proportion whose infections met McGeer et al. surveillance definitions were determined. Antimicrobial choice was compared to national prescribing guidelines and prescription duration analysed using a negative binomial mixed-effects regression model. Of 12 319 surveyed residents, 452 (3.7%) were prescribed an antimicrobial for a SSTI and 29% of these residents had confirmed infection. Topical clotrimazole was most frequently prescribed, often for unspecified indications. Where an indication was documented, antimicrobial choice was generally aligned with recommendations. Duration of prescribing (in days) was associated with use of an agent for prophylaxis (rate ratio (RR) 1.63, 95% confidence interval (CI) 1.08–2.52), PRN orders (RR 2.10, 95% CI 1.42–3.11) and prescription of a topical agent (RR 1.47, 95% CI 1.08–2.02), while documentation of a review or stop date was associated with reduced duration of prescribing (RR 0.33, 95% CI 0.25–0.43). Antimicrobial prescribing for SSTI is frequent in aged care facilities in Australia. Methods to enhance appropriate prescribing, including clinician documentation, are required. |
| Databáze: | OpenAIRE |
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