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

Identifying and definitional attributes

Metadata item type:Indicator
Indicator type:Indicator
Short name:Indicator 4b-Antibiotic-allergy mismatch in prescribing
METeOR identifier:612222
Registration status:Health, Standard 12/09/2016
Description:

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

Rationale:

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:Clinical care standard indicators: antimicrobial stewardship Health, Standard 12/09/2016
Outcome area:Use of guidelines and clinical condition Health, Standard 12/09/2016

Collection and usage attributes

Computation description:

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:

(Numerator ÷ denominator) x 100

Numerator:

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:

Number of prescriptions for antibiotics.

Comments:

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:Percentage
Data type:Real
Unit of measure:Service event
Format:

N[NN]

Source and reference attributes

Submitting organisation:

Australian Commission on Safety and Quality in Health Care

Reference documents:

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