The Commission is working with the National Centre for Antimicrobial Stewardship (NCAS) at the Doherty Institute (a joint venture between the Royal Melbourne Hospital and the University of Melbourne) to collect and analyse data on the appropriate use of antimicrobials in hospitals through the National Antimicrobial Prescribing Survey (NAPS).

NAPS is a voluntary annual audit of health services, to provide a snapshot of medication charts and patient records which have been assessed for appropriateness of antimicrobial prescribing, and compliance with guidelines.

The results from the NAPS can be used as evidence to support the antimicrobial stewardship (AMS) criterion of the National Safety and Quality Health Service (NSQHS) Standard 3: Preventing and Controlling Healthcare Associated Infections.

For more information on NAPS, or to participate in the survey, please visit the NAPS website.

2013 National Antimicrobial Prescribing Survey Report

The 2013 NAPS Report, Antimicrobial Prescribing Practice in Australia: Results of the 2013 National Antimicrobial Prescribing Survey, was released on 19 November 2014.

This Report provides important information on the antimicrobial prescribing practices in Australian hospitals. A total of 151 hospitals (132 public and 19 private) contributed to the data from every state and territory. This survey comprised approximately 13,000 individual prescriptions for 7,700 patients.

The overall findings of the 2013 NAPS demonstrate a number of areas where significant improvements can be made at the hospital level, as well as regionally and nationally.  Prominent among these are the following:

  • The appropriateness of the top five most commonly prescribed antimicrobials range from 60-76 percent. Overall, around 30 percent of prescriptions were deemed to be inappropriate.  Inappropriate use was mainly related to unnecessary use of broad-spectrum antimicrobials and incorrect duration of treatment.
  • Inappropriate prescribing was very common for patients with acute exacerbation of chronic obstructive pulmonary disease, for which 46 percent of prescriptions were noncompliant with guidelines.
  • Overall, surgical prophylaxis was the highest indication for antimicrobial use. Surgical prophylaxis was given for more than 24 hours in 41 percent of cases; this falls short of the best practice of less than 5 percent.
  • 70.9 per cent of antibiotic prescriptions had a reason documented in the medical notes.
  • The most common prescriptions were for the cephalosporin antibiotics ceftriaxone and cephazolin.

2014 National Antimicrobial Prescribing Survey

The 2014 NAPS Report, Antimicrobial prescribing practice in Australian hospitals: Results of the 2014 National Antimicrobial Prescribing Survey, was released on 24 July 2015.

A total of 248 hospitals (197 public and 51 private) participated, representing a 64 per cent increased participation level from the previous year.

The results of the 2014 survey were similar with 2013, and demonstrated a number of areas where significant improvements can be made at the hospital level, as well as regionally and nationally. In the 2014 survey:

  • Approximately one-quarter (24.3 per cent) of the 19,944 prescriptions surveyed were non-compliant with guidelines, and 23 per cent were deemed to be inappropriate.
  • 74 per cent of antimicrobials prescribed had their indications documented in the medical notes (more than 95 per cent is considered best practice).
  • Surgical prophylaxis continues to be an issue, with 35.9 per cent of the survey prescriptions continuing beyond 24 hours (less than 5 per cent is considered best practice). 40.2 per cent of prescriptions for surgical prophylaxis were also considered inappropriate, mainly due to incorrect duration and dose, and absence of an indication for an antimicrobial. The Commission is seeking to work with the Royal Australasian College of Surgeons to address this issue.
  • Infective exacerbation of chronic obstructive pulmonary disease was poorly prescribed (36.8 per cent were deemed inappropriate), as were other respiratory tract infections such as bronchitis (50.7 per cent inappropriate) and exacerbation of asthma (70.0 per cent inappropriate).
  • The most common prescribed antimicrobials were cephazolin, ceftriaxone and metronidazole.

Application of National Antimicrobial Prescribing Survey to other health sectors

The Commission is working with NCAS to expand NAPS into other health sectors. The first step will be development and piloting of a dedicated aged care module, called acNAPS, with the aim of improving AMS activities in the residential aged care facility setting. The Commission has developed the acNAPS Infographic to encourage residential aged care facilities to participate in acNAPS and to develop AMS strategies to improve appropriate antimicrobial prescribing.