Antimicrobial stewardship: 7a-The proportion of prescriptions for which an antimicrobial review and updated treatment decision is documented within 48 hours from the first prescription

The proportion of prescriptions for which an antimicrobial review and updated treatment decision is documented within 48 hours from the first prescription.

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, ‘reviewed’ means that a prescriber has assessed the antimicrobial therapy, taking into consideration any investigation results and relevant patient factors. The assessment should consider the need for ongoing antimicrobial use, appropriate microbial spectrum of activity, dose, frequency, and route of administration.

For the purposes of this indicator, a ‘documented’ decision means there is a note about the antimicrobial treatment decision in the patient's healthcare record. For example, ‘Clinically improved, afebrile, sputum and blood cultures no growth. Ceftriaxone ceased, start oral amoxicillin 1 g tds for 5 days’.

The numerator and denominator exclude long-term antimicrobial prescriptions commenced prior to admission that are not associated with the current episode of care.

Presented as a percentage.

(Numerator ÷ Denominator) x 100​

Number of prescriptions of antimicrobials for which a prescriber has reviewed the antimicrobial therapy within 48 hours from the first prescription and an updated treatment decision is documented.

Number of prescriptions for antimicrobials.

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 and subacute facilities.

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.