New report shows wide variation in antimicrobial usage in Australian hospitals

A new report on antimicrobial use in Australian hospitals shows there is wide variation in usage between hospitals, indicating that although overall usage rates have decreased slightly in recent years, there is still considerable room for improvement.

The report, Antimicrobial use in Australian hospitals: 2014 report of the National Antimicrobial Utilisation Surveillance Program (NAUSP), released today by the Australian Commission on Safety and Quality in Health Care (the Commission), provides important information on how much antimicrobials are being used in Australian hospitals.

The Commission’s Senior Medical Advisor, Professor John Turnidge, said “Antimicrobial resistance is a serious threat to public health. One of the major contributors to resistance is misuse of antibiotics. Prudent antimicrobial prescribing is essential for reducing the emergence of widespread antimicrobial resistance in pathogens. The NAUSP report provides rich data on usage patterns which can be used to develop effective antimicrobial stewardship strategies.”

The NAUSP is a passive surveillance system measuring rates of antimicrobial usage in hospital settings. The 2014 NAUSP report provides the results of data from 129 participating acute care hospitals (111 public and 18 private) ranging from principal referral hospitals to small public acute hospitals across Australia. For Australian public hospital beds, this represents more than 90 per cent of principal referral hospital beds and 82 per cent of total beds in public hospitals with more than 50 beds.

Senior Pharmacist for the NAUSP, Vicki McNeil from the SA Health Infection Control Service, said “The report shows us that there is still room for improvement in antimicrobial use in hospitals. Although Australian antimicrobial usage rates have come down marginally, they continue to be greater than in some benchmark countries, Netherlands and Sweden.”

Key findings

The 2014 NAUSP report found:

  • 20 agents accounted for 92 per cent of all antibacterials used in Australian hospitals on a defined daily dose basis, with six antibacterials representing more than 50 per cent. These included amoxicillin with clavulanic acid, flucloxacillin and cephazolin. This is similar to the findings from the 2014 National Antimicrobial Prescribing Survey, with some minor variations likely due to differences in the method of data collection.
  • In 2014, the total rate for antibacterials prescribed in Australia decreased by 2.2 per cent from 2013, which is a decrease of 6.2 per cent from Australia’s peak usage in 2010.
  • Usage rates varied widely between hospitals, with a high of 2040 and a low of 330 defined daily doses per 1000 occupied bed days. Some of this variation can be attributed to variations in complexity of care provided in different hospitals.

The NAUSP forms part of the Commission’s Antimicrobial Use and Resistance in Australia (AURA) Surveillance System, to monitor antimicrobial resistance and usage rates in Australia as a basis for prevention and containment of antimicrobial resistance.

Download the 2014 NAUSP report