Antimicrobial stewardship in aged care
Aged care is an important area of focus for the Commission in its support of improved antimicrobial stewardship in the community. The objective of this work is to support the care of older people in health and aged care settings; to improve the safe and appropriate use of antimicrobials; and, to decrease the risk of antimicrobial resistance across the community in Australia.
Why is aged care a focus area for improved prescribing?
Data from AURA 2021, the Fourth Australian report on antimicrobial use and resistance in human health, show that, for some organisms, rates of antimicrobial resistance in aged care are as high, or higher, than rates in hospitals.
AURA 2021 also includes data from the 2019 Aged Care National Antimicrobial Prescribing Survey (NAPS) that shows antimicrobials are being used in aged care for conditions where they are not required, such as urinary tract, soft tissue and skin infections. Almost 1 in 6 antimicrobials in the aged care setting were prescribed for use “when required”, which may lead to unnecessarily long treatment duration and increase the risk of antimicrobial resistance. A large number of antimicrobial prescriptions in residential aged care services were for the prevention of infections, which is concerning because antimicrobials should rarely be used to prevent infection in this setting.
There are a number of resources available to support aged care homes, and those involved in the care of older people, that can support improved antimicrobial prescribing.
Useful Commission resources:
Useful external resources:
- The NPS MedicineWise/Commission Antimicrobial prescribing modules - https://learn.nps.org.au/mod/page/view.php?id=4282 in particular Catheter-associated urinary tract infection
Other resources:
- NCAS NAPS Website - https://www.naps.org.au/Default.aspx - to participate in Aged Care NAPS
- NCAS aged care resources - https://www.ncas-australia.org/aged-care-resources
- Aged Care Quality and Safety Commission - https://www.agedcarequality.gov.au/
- Royal Commission into Aged Care Quality and Safety - https://agedcare.royalcommission.gov.au/