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Skin and soft tissue infections and current antimicrobial prescribing practices in Australian aged care residents
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. Th...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cambridge University Press
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6519684/ https://www.ncbi.nlm.nih.gov/pubmed/30869059 http://dx.doi.org/10.1017/S0950268819000128 |
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author | Bennett, N. J. Imam, N. Ingram, R. J. James, R. S. Buising, K. L. Bull, A. L. Chen, C. S. Thursky, K. A. Worth, L. J. |
author_facet | Bennett, N. J. Imam, N. Ingram, R. J. James, R. S. Buising, K. L. Bull, A. L. Chen, C. S. Thursky, K. A. Worth, L. J. |
author_sort | Bennett, N. J. |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-6519684 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Cambridge University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-65196842019-06-04 Skin and soft tissue infections and current antimicrobial prescribing practices in Australian aged care residents Bennett, N. J. Imam, N. Ingram, R. J. James, R. S. Buising, K. L. Bull, A. L. Chen, C. S. Thursky, K. A. Worth, L. J. Epidemiol Infect Original Paper 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. Cambridge University Press 2019-02-22 /pmc/articles/PMC6519684/ /pubmed/30869059 http://dx.doi.org/10.1017/S0950268819000128 Text en © Cambridge University Press 2019 http://creativecommons.org/licenses/by/4.0/ This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Paper Bennett, N. J. Imam, N. Ingram, R. J. James, R. S. Buising, K. L. Bull, A. L. Chen, C. S. Thursky, K. A. Worth, L. J. Skin and soft tissue infections and current antimicrobial prescribing practices in Australian aged care residents |
title | Skin and soft tissue infections and current antimicrobial prescribing practices in Australian aged care residents |
title_full | Skin and soft tissue infections and current antimicrobial prescribing practices in Australian aged care residents |
title_fullStr | Skin and soft tissue infections and current antimicrobial prescribing practices in Australian aged care residents |
title_full_unstemmed | Skin and soft tissue infections and current antimicrobial prescribing practices in Australian aged care residents |
title_short | Skin and soft tissue infections and current antimicrobial prescribing practices in Australian aged care residents |
title_sort | skin and soft tissue infections and current antimicrobial prescribing practices in australian aged care residents |
topic | Original Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6519684/ https://www.ncbi.nlm.nih.gov/pubmed/30869059 http://dx.doi.org/10.1017/S0950268819000128 |
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