Dataset Information

Antibiotic prescribing in neonatal sepsis: an Australian nationwide survey.

ABSTRACT:

Objective

To evaluate quality and variation in antibiotic prescribing for neonatal sepsis.

Design

We analysed prescribing in hospitalised neonates using the National Antimicrobial Prescribing Survey in Australian neonates from 1 January 2014 to 31 December 2018.

Setting

Data from antibiotic point prevalence surveys performed in hospitals, ranging from rural hospitals to tertiary paediatric and maternity hospitals within Australia.

Patients

Admitted neonates <28 days of age from participating hospitals.

Main outcome measures

Variation and appropriateness in prescribing for neonatal sepsis and variation in dosing for gentamicin and benzylpenicillin across hospitals.

Results

A total of 415 prescriptions among 214 neonates from 39 different hospitals were included. The majority of prescriptions (342, 82.4%) were for neonates <7 days of age. The most commonly prescribed antibiotics were gentamicin and benzylpenicillin, with 323 (77.8%) prescriptions. Dosing variability was substantial, with doses ranging from 2 to 8 mg/kg for gentamicin (median 5?mg/kg, IQR 4-5) and from 45 to 72?mg/kg for benzylpenicillin (median 60?mg/kg, IQR 50-60), although only 13 (3.2%) and 19 (4.6%) prescriptions were locally assessed as inappropriate or non-compliant with guidelines, respectively. At time of audit, 22% of antibiotics had been given for more than 48?hours and 9% more than 72?hours, although microbiologically confirmed infection was documented in only nine (4.2%) neonates.

Conclusions

Prescribing for neonatal sepsis was dominated by use of benzylpenicillin and gentamicin with substantial variation in dosing. A small minority had culture-confirmed infection. Efforts to standardise antibiotic dosing and duration for suspected neonatal sepsis are recommended.

SUBMITTER: McMullan B

PROVIDER: S-EPMC7101048 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Antibiotic prescribing in neonatal sepsis: an Australian nationwide survey.

McMullan Brendan B Cooper Celia C Spotswood Naomi N James Rodney R Jones Cheryl C Konecny Pamela P Blyth Christopher C Karen Thursky T

BMJ paediatrics open 20200317 1

<h4>Objective</h4>To evaluate quality and variation in antibiotic prescribing for neonatal sepsis.<h4>Design</h4>We analysed prescribing in hospitalised neonates using the National Antimicrobial Prescribing Survey in Australian neonates from 1 January 2014 to 31 December 2018.<h4>Setting</h4>Data from antibiotic point prevalence surveys performed in hospitals, ranging from rural hospitals to tertiary paediatric and maternity hospitals within Australia.<h4>Patients</h4>Admitted neonates <28 days ...[more]

PMID: 32232180

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Project description:OBJECTIVES:To explore: (1) the views of Australian physiotherapists regarding potential implementation of non-medical prescribing in Australia, (2) how the geographical location and health sector in which a clinician works may influence their perceptions and (3) the perceptions of Australian physiotherapists about how physiotherapist prescribing might impact the care that the profession can provide. DESIGN:A cross-sectional descriptive survey using open and closed questions. SETTING:Participants completed an online questionnaire. PARTICIPANTS:883 Australian Health Professionals Registration Authority (AHPRA)-registered physiotherapists, working across all states and territories. OUTCOME MEASURES:An online questionnaire was developed by a panel of subject experts and pretested (n=10) for internal consistency. A hyperlink to the questionnaire was emailed to all members of the Australian Physiotherapy Association. A reminder email was sent 4 weeks later. Quantitative data were analysed descriptively, with use of absolute risk reductions (ARRs) and 95% CIs to determine the likelihood that health sector or geographical location were associated with specific views. Thematic analysis enabled synthesis of the qualitative data. RESULTS:79.0% participants felt that physiotherapist prescribing should be introduced in Australia, with 71.2% wanting to train as prescribers. Clinical governance, risk management, regulation of clinicians and the development of an education framework were identified as priorities for implementation. Participants working in the private sector were significantly more likely to train as prescribers than those in the public sector (ARR 9.9%; 95% CI 3.5 to 16.4) or educational/research institutions (ARR 23.3%; 95% CI 12.8 to 33.8), with city dwellers significantly more likely to train compared with physiotherapists in remote regions (ARR 19.8%; 95% CI 0.8 to 39.2). Physiotherapist prescribing was predicted to improve efficiency of healthcare delivery, access to medicines and reductions in healthcare costs. CONCLUSIONS:AHPRA-registered physiotherapists perceive that the introduction of autonomous physiotherapist prescribing would be beneficial for the Australian population and should be introduced. Decision makers should consider the results of this survey in conjunction with cost-benefit and risk analysis when planning the introduction of physiotherapist prescribing.

Dataset Information

Antibiotic prescribing in neonatal sepsis: an Australian nationwide survey.

Objective

Design

Setting

Patients

Main outcome measures

Results

Conclusions

Publications

Antibiotic prescribing in neonatal sepsis: an Australian nationwide survey.

Similar Datasets

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