Community-Based Prescribing for Impetigo in Remote Australia: An Opportunity for Antimicrobial Stewardship
BackgroundTo support antibiotic prescribing for both hospital and community-based health professionals working in remote North Western Australia, a multidisciplinary Antimicrobial Stewardship (AMS) Committee was established in 2013. This Committee is usually focused on hospital-based prescribing. A...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2017-07-01
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| Series: | Frontiers in Public Health |
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| Online Access: | http://journal.frontiersin.org/article/10.3389/fpubh.2017.00158/full |
| _version_ | 1818232787722829824 |
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| author | Stefanie Jane Oliver James Cush Jeanette E. Ward Jeanette E. Ward |
| author_facet | Stefanie Jane Oliver James Cush Jeanette E. Ward Jeanette E. Ward |
| author_sort | Stefanie Jane Oliver |
| collection | DOAJ |
| description | BackgroundTo support antibiotic prescribing for both hospital and community-based health professionals working in remote North Western Australia, a multidisciplinary Antimicrobial Stewardship (AMS) Committee was established in 2013. This Committee is usually focused on hospital-based prescribing. A troubling increase in sulfamethoxazole/trimethoprim resistance in Staphylococcus aureus antibiograms from 9 to 18% over 1 year prompted a shift in gaze to community prescribing.What we didFinding a paucity of relevant research, we first investigated contextual factors influencing local prescribing. We also designed a systematic survey of experts with experience relevant to our setting using a structured response survey (12 questions) to better understand specific AMS risks. Using these findings, recommendations were formulated for the AMS Committee.What we learnedPrescribing recommendations in a regional Skin Infections Protocol had previously been altered in December 2014. From 15 experts, we received 9 comprehensive responses (60%) about AMS risks in community prescribing. If feasible, prescribing audits also would have been valuable. Ten recommendations regarding specific antibiotic recommendations were submitted to the AMS Committee.Strengthening AMS in remote settingsAs AMS Committees in Australia usually focus on hospital-based prescribing, novel methods such as external expert opinion could inform deliberations about community-based prescribing. Our approach meant that this AMS Committee was able to intervene in the 2017 organizational review of the regional Skin Infections Protocol used by prescribers likely unaware of AMS risks. This experience demonstrates the value of incorporating AMS principles in community-based prescribing in context of a remote setting. |
| first_indexed | 2024-12-12T11:11:50Z |
| format | Article |
| id | doaj.art-8b96a700914c4f2ebbe018119f5f8a65 |
| institution | Directory Open Access Journal |
| issn | 2296-2565 |
| language | English |
| last_indexed | 2024-12-12T11:11:50Z |
| publishDate | 2017-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Public Health |
| spelling | doaj.art-8b96a700914c4f2ebbe018119f5f8a652022-12-22T00:26:16ZengFrontiers Media S.A.Frontiers in Public Health2296-25652017-07-01510.3389/fpubh.2017.00158246331Community-Based Prescribing for Impetigo in Remote Australia: An Opportunity for Antimicrobial StewardshipStefanie Jane Oliver0James Cush1Jeanette E. Ward2Jeanette E. Ward3Pharmacy Department, Western Australia Country Health Service (WACHS)-Kimberley, Broome, WA, AustraliaPaediatrics Department, Western Australia Country Health Service (WACHS)-Kimberley, Broome, WA, AustraliaKimberley Population Health Unit, Western Australia Country Health Service (WACHS)-Kimberley, Broome, WA, AustraliaNulungu Research Institute, University of Notre Dame Australia, Broome, WA, AustraliaBackgroundTo support antibiotic prescribing for both hospital and community-based health professionals working in remote North Western Australia, a multidisciplinary Antimicrobial Stewardship (AMS) Committee was established in 2013. This Committee is usually focused on hospital-based prescribing. A troubling increase in sulfamethoxazole/trimethoprim resistance in Staphylococcus aureus antibiograms from 9 to 18% over 1 year prompted a shift in gaze to community prescribing.What we didFinding a paucity of relevant research, we first investigated contextual factors influencing local prescribing. We also designed a systematic survey of experts with experience relevant to our setting using a structured response survey (12 questions) to better understand specific AMS risks. Using these findings, recommendations were formulated for the AMS Committee.What we learnedPrescribing recommendations in a regional Skin Infections Protocol had previously been altered in December 2014. From 15 experts, we received 9 comprehensive responses (60%) about AMS risks in community prescribing. If feasible, prescribing audits also would have been valuable. Ten recommendations regarding specific antibiotic recommendations were submitted to the AMS Committee.Strengthening AMS in remote settingsAs AMS Committees in Australia usually focus on hospital-based prescribing, novel methods such as external expert opinion could inform deliberations about community-based prescribing. Our approach meant that this AMS Committee was able to intervene in the 2017 organizational review of the regional Skin Infections Protocol used by prescribers likely unaware of AMS risks. This experience demonstrates the value of incorporating AMS principles in community-based prescribing in context of a remote setting.http://journal.frontiersin.org/article/10.3389/fpubh.2017.00158/fullantimicrobial stewardshipcommunity-based prescribingremote indigenous healthimpetigoStreptococcus pyogenes |
| spellingShingle | Stefanie Jane Oliver James Cush Jeanette E. Ward Jeanette E. Ward Community-Based Prescribing for Impetigo in Remote Australia: An Opportunity for Antimicrobial Stewardship Frontiers in Public Health antimicrobial stewardship community-based prescribing remote indigenous health impetigo Streptococcus pyogenes |
| title | Community-Based Prescribing for Impetigo in Remote Australia: An Opportunity for Antimicrobial Stewardship |
| title_full | Community-Based Prescribing for Impetigo in Remote Australia: An Opportunity for Antimicrobial Stewardship |
| title_fullStr | Community-Based Prescribing for Impetigo in Remote Australia: An Opportunity for Antimicrobial Stewardship |
| title_full_unstemmed | Community-Based Prescribing for Impetigo in Remote Australia: An Opportunity for Antimicrobial Stewardship |
| title_short | Community-Based Prescribing for Impetigo in Remote Australia: An Opportunity for Antimicrobial Stewardship |
| title_sort | community based prescribing for impetigo in remote australia an opportunity for antimicrobial stewardship |
| topic | antimicrobial stewardship community-based prescribing remote indigenous health impetigo Streptococcus pyogenes |
| url | http://journal.frontiersin.org/article/10.3389/fpubh.2017.00158/full |
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