Antimicrobial stewardship in remote primary healthcare across northern Australia
Background The high burden of infectious disease and associated antimicrobial use likely contribute to the emergence of antimicrobial resistance in remote Australian Aboriginal communities. We aimed to develop and apply context-specific tools to audit antimicrobial use in the remote primary healthca...
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| Format: | Article |
| Language: | English |
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PeerJ Inc.
2020-07-01
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| Series: | PeerJ |
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| Online Access: | https://peerj.com/articles/9409.pdf |
| _version_ | 1797418187530174464 |
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| author | Will Cuningham Lorraine Anderson Asha C. Bowen Kirsty Buising Christine Connors Kathryn Daveson Joanna Martin Stacey McNamara Bhavini Patel Rodney James John Shanks Kerr Wright Trent Yarwood Steven YC Tong Jodie McVernon |
| author_facet | Will Cuningham Lorraine Anderson Asha C. Bowen Kirsty Buising Christine Connors Kathryn Daveson Joanna Martin Stacey McNamara Bhavini Patel Rodney James John Shanks Kerr Wright Trent Yarwood Steven YC Tong Jodie McVernon |
| author_sort | Will Cuningham |
| collection | DOAJ |
| description | Background The high burden of infectious disease and associated antimicrobial use likely contribute to the emergence of antimicrobial resistance in remote Australian Aboriginal communities. We aimed to develop and apply context-specific tools to audit antimicrobial use in the remote primary healthcare setting. Methods We adapted the General Practice version of the National Antimicrobial Prescribing Survey (GP NAPS) tool to audit antimicrobial use over 2–3 weeks in 15 remote primary healthcare clinics across the Kimberley region of Western Australia (03/2018–06/2018), Top End of the Northern Territory (08/2017–09/2017) and far north Queensland (05/2018–06/2018). At each clinic we reviewed consecutive clinic presentations until 30 presentations where antimicrobials had been used were included in the audit. Data recorded included the antimicrobials used, indications and treating health professional. We assessed the appropriateness of antimicrobial use and functionality of the tool. Results We audited the use of 668 antimicrobials. Skin and soft tissue infections were the dominant treatment indications (WA: 35%; NT: 29%; QLD: 40%). Compared with other settings in Australia, narrow spectrum antimicrobials like benzathine benzylpenicillin were commonly given and the appropriateness of use was high (WA: 91%; NT: 82%; QLD: 65%). While the audit was informative, non-integration with practice software made the process manually intensive. Conclusions Patterns of antimicrobial use in remote primary care are different from other settings in Australia. The adapted GP NAPS tool functioned well in this pilot study and has the potential for integration into clinical care. Regular stewardship audits would be facilitated by improved data extraction systems. |
| first_indexed | 2024-03-09T06:28:54Z |
| format | Article |
| id | doaj.art-72f375f333984b0893a815c7f2aeb388 |
| institution | Directory Open Access Journal |
| issn | 2167-8359 |
| language | English |
| last_indexed | 2024-03-09T06:28:54Z |
| publishDate | 2020-07-01 |
| publisher | PeerJ Inc. |
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| series | PeerJ |
| spelling | doaj.art-72f375f333984b0893a815c7f2aeb3882023-12-03T11:10:42ZengPeerJ Inc.PeerJ2167-83592020-07-018e940910.7717/peerj.9409Antimicrobial stewardship in remote primary healthcare across northern AustraliaWill Cuningham0Lorraine Anderson1Asha C. Bowen2Kirsty Buising3Christine Connors4Kathryn Daveson5Joanna Martin6Stacey McNamara7Bhavini Patel8Rodney James9John Shanks10Kerr Wright11Trent Yarwood12Steven YC Tong13Jodie McVernon14Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, AustraliaKimberley Aboriginal Medical Services, Kimberley, Western Australia, AustraliaMenzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, AustraliaThe Peter Doherty Institute for Infection and Immunity, The Royal Melbourne Hospital and The University of Melbourne, Melbourne, Victoria, AustraliaTop End Health Service, NT Department of Health, Darwin, Northern Territory, AustraliaQueensland Statewide Antimicrobial Stewardship Program, Metro North Hospital and Health Service, Brisbane, Queensland, AustraliaKimberley Aboriginal Medical Services, Kimberley, Western Australia, AustraliaQueensland Statewide Antimicrobial Stewardship Program, Metro North Hospital and Health Service, Brisbane, Queensland, AustraliaTop End Health Service, NT Department of Health, Darwin, Northern Territory, AustraliaThe Peter Doherty Institute for Infection and Immunity, The Royal Melbourne Hospital and The University of Melbourne, Melbourne, Victoria, AustraliaTop End Health Service, NT Department of Health, Darwin, Northern Territory, AustraliaKimberley Aboriginal Medical Services, Kimberley, Western Australia, AustraliaQueensland Statewide Antimicrobial Stewardship Program, Metro North Hospital and Health Service, Brisbane, Queensland, AustraliaMenzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, AustraliaThe Peter Doherty Institute for Infection and Immunity, The Royal Melbourne Hospital and The University of Melbourne, Melbourne, Victoria, AustraliaBackground The high burden of infectious disease and associated antimicrobial use likely contribute to the emergence of antimicrobial resistance in remote Australian Aboriginal communities. We aimed to develop and apply context-specific tools to audit antimicrobial use in the remote primary healthcare setting. Methods We adapted the General Practice version of the National Antimicrobial Prescribing Survey (GP NAPS) tool to audit antimicrobial use over 2–3 weeks in 15 remote primary healthcare clinics across the Kimberley region of Western Australia (03/2018–06/2018), Top End of the Northern Territory (08/2017–09/2017) and far north Queensland (05/2018–06/2018). At each clinic we reviewed consecutive clinic presentations until 30 presentations where antimicrobials had been used were included in the audit. Data recorded included the antimicrobials used, indications and treating health professional. We assessed the appropriateness of antimicrobial use and functionality of the tool. Results We audited the use of 668 antimicrobials. Skin and soft tissue infections were the dominant treatment indications (WA: 35%; NT: 29%; QLD: 40%). Compared with other settings in Australia, narrow spectrum antimicrobials like benzathine benzylpenicillin were commonly given and the appropriateness of use was high (WA: 91%; NT: 82%; QLD: 65%). While the audit was informative, non-integration with practice software made the process manually intensive. Conclusions Patterns of antimicrobial use in remote primary care are different from other settings in Australia. The adapted GP NAPS tool functioned well in this pilot study and has the potential for integration into clinical care. Regular stewardship audits would be facilitated by improved data extraction systems.https://peerj.com/articles/9409.pdfAntimicrobial stewardshipRemote primary healthcareIndigenous HealthAntimicrobial resistanceInfectious diseaseAntimicrobial use |
| spellingShingle | Will Cuningham Lorraine Anderson Asha C. Bowen Kirsty Buising Christine Connors Kathryn Daveson Joanna Martin Stacey McNamara Bhavini Patel Rodney James John Shanks Kerr Wright Trent Yarwood Steven YC Tong Jodie McVernon Antimicrobial stewardship in remote primary healthcare across northern Australia PeerJ Antimicrobial stewardship Remote primary healthcare Indigenous Health Antimicrobial resistance Infectious disease Antimicrobial use |
| title | Antimicrobial stewardship in remote primary healthcare across northern Australia |
| title_full | Antimicrobial stewardship in remote primary healthcare across northern Australia |
| title_fullStr | Antimicrobial stewardship in remote primary healthcare across northern Australia |
| title_full_unstemmed | Antimicrobial stewardship in remote primary healthcare across northern Australia |
| title_short | Antimicrobial stewardship in remote primary healthcare across northern Australia |
| title_sort | antimicrobial stewardship in remote primary healthcare across northern australia |
| topic | Antimicrobial stewardship Remote primary healthcare Indigenous Health Antimicrobial resistance Infectious disease Antimicrobial use |
| url | https://peerj.com/articles/9409.pdf |
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