Appropriateness of acute-care antibiotic prescriptions for community-acquired infections and surgical antibiotic prophylaxis in England: analysis of 2016 national point prevalence survey data

• DOI: 10.1016/j.jhin.2023.10.006
• Publication Date: 2023-10-17T07:04:56Z
• Authors: H. Higgins; R. Freeman; A. Doble; G. Hood; J. Islam; S. Gerver; K.L. Henderson; A. Demirjian; S. Hopkins; D. Ashiru-Oredope
• Keywords: Antimicrobial Stewardship; Drug Utilization Review

Estimates of inappropriate prescribing can highlight key target areas for antimicrobial stewardship (AMS) and inform national targets.To (1) define (2) produce estimates antibiotic levels within acute hospital trusts in England.The 2016 Healthcare-Associated Infections (HAI), Antimicrobial Use (AMU) AMS point prevalence survey (PPS) was used to derive prescribing, focusing on the four most reported community-acquired indications (CAIs) PPS surgical prophylaxis. Definitions appropriate therapy each indication were developed through compilation treatment guidelines. A Likert-scale system appropriateness coding validated refined a two-stage expert review process.Antimicrobial usage data collected 25,741 individual prescriptions, representing 17,884 patients 213 hospitals England. 30.4% prescriptions CAIs interest estimated be (2054 prescriptions). The highest percentage occurred uncomplicated cystitis (62.5%), followed by bronchitis (48%). For prophylaxis, 30.8% terms dose number, 21.3% excess prophylaxis duration.The England approximated 30.4%; this establishes baseline provided where interventions should prioritized. Our definitions appraised choice, duration number (surgical only); however, they did not consider other aspects appropriateness, such as combination - is an important area future work.