Antimicrobial stewardship: 2a-The proportion of antimicrobial prescriptions that are in accordance with the current Therapeutic Guidelines or evidence-based, locally endorsed guidelines

The proportion of antimicrobial prescriptions that are in accordance with the current Therapeutic Guidelines or evidence-based, locally endorsed guidelines.

For the numerator and denominator, there may be one or more prescriptions for any one patient during an episode of care. All prescriptions meeting the criteria for the numerator or the denominator should be counted.

For the numerator, 'in accordance’ means that the antimicrobial prescription aligns with the choice of antimicrobial (active ingredient), dose, frequency and route of administration, and duration of therapy as per the current Therapeutic Guidelines or evidence-based, locally endorsed guidelines.

Presented as a percentage.

(Numerator ÷ Denominator) x 100​

Number of prescriptions for an antimicrobial that are in accordance with the current Therapeutic Guidelines or evidence-based, locally endorsed guidelines.

Number of prescriptions for antimicrobials for conditions that have documented guidelines on the use of antimicrobials.

As per the Antimicrobial Stewardship Clinical Care Standard (ACSQHC 2020), the term ‘locally endorsed guidelines’ should meet the following specific requirements:  

Therapeutic Guidelines: Antibiotic provides national, evidence-based guidelines for antimicrobial use in Australia. However, in some cases, evidence-based and formally endorsed local adaptations may be more relevant to local patterns of antimicrobial resistance or specific patient populations requiring a localised approach or with highly specialised diagnoses out of the scope of Therapeutic Guidelines. Ensure that local adaptations of guidelines are based on Therapeutic Guidelines and, where they deviate, a clear rationale based on published clinical evidence and local epidemiology is documented and endorsed by a governing body. Endorsing bodies may include peer review at a drug and therapeutics, antimicrobial stewardship or medicines advisory committee, or equivalent.

See the Antimicrobial Stewardship Clinical Care Standard (ACSQHC 2020) for key considerations to optimise the use of antimicrobials.

N[NN]

Applicable settings:

All hospital settings, including public and private hospitals, acute, subacute facilities, outpatient and day procedure services

General practice and other community and primary healthcare settings such as Hospital in the Home, Aboriginal community controlled health services, dental practices and community pharmacies

Residential aged care services.

Australian Commission on Safety and Quality in Health Care

Australian Commission on Safety and Quality in Health Care. Antimicrobial Stewardship Clinical Care Standard. Sydney: ACSQHC; 2020.