Antimicrobial use in Australian hospitals

The National Antimicrobial Utilisation Surveillance Program (NAUSP) collects data on the volume of antimicrobial usage in Australian hospitals.

About NAUSP

NAUSP, is administered by SA Health. NAUSP is a voluntary program that focuses on standardised measurement of antimicrobial use in Australian adult public and private hospitals. Antimicrobial usage for adult hospitals is measured in defined daily doses per 1,000 occupied bed days. In excess of 200 hospitals from all states and territories currently contribute to NAUSP; including all Principal Referral Hospitals.

NAUSP provides an important tool for hospitals to support their local antimicrobial stewardship (AMS) programs. Participation in NAUSP can also assist hospitals to meeting the AMS requirements of the National Safety and Quality Health Service (NSQHS) Standard Preventing and Controlling Healthcare-Associated Infection .

The Commission has published a series of reports on analyses of NAUSP data. NAUSP routinely publishes six monthly benchmarking reports for hospital peer groups, speciality units, states and territories.

For more information about NAUSP, including becoming a contributor, visit the NAUSP website.

NAUSP paediatric feasibility study

Antimicrobial usage in paediatric hospital inpatient populations is not currently monitored through NAUSP, primarily due to the lack of a universally accepted method to measure antimicrobial use in this population.

NAUSP and the Commission conducted a project to assess the feasibility, challenges and accuracy of different methods for measuring antimicrobial use in Australian paediatric hospital inpatients. Six Australian specialist paediatric hospitals submitted dispensing data, patient administration data and occupancy data from two wards each for the month of June 2018 for the project. Administration data were collected from electronic medicine management (EMM) systems in hospitals where these operated, or through manual review of medication charts.

The six hospitals were:

  • Sydney Children’s Hospital, Sydney Children’s Hospital Network, New South Wales
  • Westmead Children’s Hospital, Sydney Children’s Hospital Network, New South Wales
  • John Hunter Children’s Hospital, New South Wales
  • Royal Children’s Hospital, Victoria
  • Monash Children’s Hospital, Victoria
  • Women’s and Children’s Hospital, South Australia.

The casemix of these wards was diverse, including: general medical, surgical, adolescent, baby, intensive care, oncology, neurology, orthopaedic, cystic fibrosis, renal, cardiac, neurosurgery, metabolic, endocrine, gastroenterology and hepatology services.

One vial per dose policies were in place in 60% of the hospitals. The hospitals used either the Australian Medicines Handbook Children’s Dosing Companion  as the antimicrobial dosing reference or Therapeutic Guidelines: Antibiotic.

The short data collection period and variety of wards that were able to contribute data limited capacity for analyses of the utility of the usual dispensing data submitted to NAUSP as a metric for monitoring antimicrobial use in paediatric hospitals.

The study was a very valuable piece of work, which aimed to support and improve antimicrobial stewardship in paediatric services.  However, following review of the results of the study and limitations, it was determined that, in the absence of widespread use of electronic medication management (EMM) systems in hospitals, it is not currently feasible to expand NAUSP to paediatric services. Limitations related to the ability to collect individual patient data, such as administration details, patient weight or days of therapy (DOTs) to continuously monitor paediatric antimicrobial usage using the paediatric preferred methods of DOTs.

Options for surveillance of antimicrobial usage in Australian paediatric hospitals through NAUSP will be considered further when EMM has been more widely implemented.  

NAUSP reports