METHODS: A retrospective analysis was conducted with data from the National Antimicrobial Prescribing Survey (NAPS). SSTI prescribing data from Hospital NAPS (2013-2022) and surgical site infection data from Surgical NAPS (2016-2022) datasets were analysed. Variables assessed included guideline compliance, appropriateness as per the structured NAPS algorithm, and reasons for inappropriateness.
RESULTS: From the Hospital NAPS dataset, 40,535 antimicrobial prescriptions for SSTIs were analysed. The most common indication was cellulitis (34.1%, N=13,822), and the most prescribed antimicrobial was flucloxacillin (18.8%, N=7,638). SSTI indications had a lower rate of guideline compliance but a higher rate of appropriateness compared with all other indications for antimicrobial prescriptions (guideline compliance 66.3%, N=21,035 vs 67.4%, N=156,285; appropriateness 75.6%, N=30,639 vs 72.7%, N=209,383). The most common reason for inappropriateness was incorrect dose or frequency (29.3%, N=2367). From the Surgical NAPS dataset, 5674 prescriptions for surgical site infections were analysed. Of these, 68.2% (N=3867) were deemed to be appropriate. The most common reason for inappropriateness was incorrect dose or frequency (27.7%, N=350).
CONCLUSIONS: As SSTIs are a common indication for prescribing an antimicrobial in Australian hospitals, identifying effective antimicrobial stewardship strategies to optimize antimicrobial use for SSTI management is recommended to improve patient outcomes.
方法:对来自全国抗菌药物处方调查(NAPS)的数据进行回顾性分析。分析了来自医院NAPS(2013-2022)的SSTI处方数据和来自手术NAPS(2016-2022)数据集的手术部位感染数据。评估的变量包括指导方针合规性,根据结构化NAPS算法的适当性和不适当的原因。
结果:来自医院NAPS数据集,分析了40,535种SSTI的抗菌处方。最常见的适应症是蜂窝织炎(34.1%;n=13,822),处方最多的抗菌药物是氟氯西林(18.8%;n=7,638)。SSTI适应症的指南依从性较低,但与所有其他抗菌药物处方适应症相比,适当性率更高(指南依从性66.3%,n=21,035vs67.4%,n=156,285适当性75.6%,n=30,639vs72.7%,n=209,383)。不适当的最常见原因是剂量或频率不正确(29.3%;n=2,367)。从外科NAPS数据集中,分析了5,674例手术部位感染的处方。68.2%(n=3,867)被认为是合适的。不适当的最常见原因是剂量或频率不正确(27.7%;n=350)。
结论:由于SSTI是澳大利亚医院处方抗菌药物的常见适应症,因此,建议确定有效的抗菌药物管理策略,以优化SSTI管理的抗菌药物使用,从而改善患者预后.