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Antimicrobial stewardship: 4b-Antibiotic-allergy mismatch in prescribing

Identifying and definitional attributes

Metadata item type:Help on this termIndicator
Indicator type:Help on this termIndicator
Short name:Help on this termIndicator 4b-Antibiotic-allergy mismatch in prescribing
METeOR identifier:Help on this term612222
Registration status:Help on this termHealth, Standard 12/09/2016
Description:Help on this term

The proportion of antibiotic prescriptions that have been classified as causing hypersensitivity for patients.

Rationale:Help on this term

Preventing adverse outcomes from known allergies and adverse drug reactions to antibiotics can avoid significant harm to patients and reduce potentially avoidable hospitalisation (Antibiotic Expert Group 2014).

Indicator set:Help on this termClinical care standard indicators: antimicrobial stewardship Health, Standard 12/09/2016
Outcome area:Help on this termUse of guidelines and clinical condition Health, Standard 12/09/2016

Collection and usage attributes

Computation description:Help on this term

A patient being prescribed an antibiotic that belongs to a therapeutic class that has been documented in the patient's medication chart or medical notes as causing ‘hypersensitivity’ is known as an 'allergy mismatch'.

For the numerator, the following may be documented in the patient's medication chart or medical notes:

  • that there has been 'hypersensitivity' or an 'allergy mismatch'
  • specific reactions, such as urticaria, angioedema, bronchospasm or anaphylaxis; and including common adverse drug reactions, such as rash.

For the numerator, recommendations regarding penicillin hypersensitivity should align with those in Therapeutic guidelines: antibiotic.

Presented as a percentage.

Computation:Help on this term

(Numerator ÷ denominator) x 100

Numerator:Help on this term

Number of prescriptions whereby the prescribed antibiotic belongs to a therapeutic class that has been documented in a patient's medication chart or medical notes as causing ‘hypersensitivity’.

Denominator:Help on this term

Number of prescriptions for antibiotics.

Comments:Help on this term

There are a number of existing audit tools where samples of medication charts are assessed for appropriateness and compliance of antimicrobial prescribing against the Therapeutic guidelines: antibiotic (Antibiotic Expert Group 2014). These include:

  • The National Antimicrobial Prescribing Survey (NAPS)–conducted by the Centre of Research Excellence–National Centre for Antimicrobial Stewardship (NCAS), using a point prevalence survey.
  • ‚ÄčAudits of GP prescribing administered by the National Prescribing Service (NPS) MedicineWise. These include, but are not confined to, antimicrobial prescribing.

Representational attributes

Representation class:Help on this termPercentage
Data type:Help on this termReal
Unit of measure:Help on this termService event
Format:Help on this term

N[NN]

Source and reference attributes

Submitting organisation:Help on this term

Australian Commission on Safety and Quality in Health Care

Reference documents:Help on this term

Antibiotic Expert Group 2014. Therapeutic guidelines: antibiotic. Version 15. Melbourne: Therapeutic Guidelines Limited.

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