University of Tasmania
Browse

File(s) under permanent embargo

Concordance with antibiotic guidelines in Australian primary care: a retrospective study of prior‐to‐hospital therapy

journal contribution
posted on 2023-05-20, 07:24 authored by O'Keefe, C, Angus ThompsonAngus Thompson, McKenzie, D, Kenneth LeeKenneth Lee

Background: Appropriate antibiotic prescribing improves patient outcomes and miti‐ gates antimicrobial resistance. As the majority of antibiotics are used in the commu‐ nity, rational prescribing in this setting is of paramount importance.

Objectives: We aimed to (1) evaluate the concordance of community antibiotic pre‐ scribing with guidelines for three common infection types among patients who pre‐ sented to hospital, and (2) identify relationships between guideline concordance and patient‐related factors.

Methods: Medical records were evaluated from the Royal Hobart Hospital (Tasmania, Australia) for patients presenting with respiratory tract, urinary tract or skin and soft tissue infections within a 12‐month period. Prior‐to‐hospital antibiotic therapy was assessed for concordance with prescribing guidelines based on presenting diagno‐ sis. Concordance was assessed against first‐line recommendations in the Australian Therapeutic Guidelines ‐ Antibiotic, based on drug choice, dose, frequency and patient factors. Descriptive statistics were performed to address Objective 1. Multivariate logistic regressions were conducted to address Objective 2 with the fol‐ lowing independent variables: infection type, age, allergies, diabetes status, gender and residential setting.

Results: A total of 285 patient records were eligible for data analysis; 28.8% (n = 82) were fully guideline concordant. The most common reason for non‐concordance was inappropriate drug choice (n = 143, 50.2%). Patients with the following charac‐ teristics were less likely to receive concordant therapy: diabetes (OR = 0.3, 95% CI 0.1‐0.8, P = .02) and increasing age (OR = 0.99, 95% CI 0.98‐1.00, P = .04).

Conclusions: Almost three‐quarters of patients received community‐initiated an‐ tibiotic therapy that was not fully guideline concordant. Antimicrobial stewardship interventions are urgently needed to improve guideline concordance for community‐ initiated antibiotic therapy.

History

Publication title

International Journal of Clinical Practice

Volume

73

Issue

12

Article number

e13427

Number

e13427

Pagination

1-11

ISSN

1368-5031

Department/School

School of Pharmacy and Pharmacology

Publisher

Blackwell Publishing Ltd

Place of publication

9600 Garsington Rd, Oxford, England, Oxon, Ox4 2Dg

Rights statement

Copyright 2019 John Wiley & Sons Ltd

Repository Status

  • Restricted

Socio-economic Objectives

Clinical health not elsewhere classified

Usage metrics

    University Of Tasmania

    Exports

    RefWorks
    BibTeX
    Ref. manager
    Endnote
    DataCite
    NLM
    DC