Page 4519 - Week 12 - Thursday, 26 October 2017
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Health—antibiotics
(Question No 498)
Mrs Dunne asked the Minister for Health and Wellbeing, upon notice, on 18 August 2017:
(1) What is ACT Health’s clinical policy in relation to the administration of antibiotic drugs to patients in hospitals.
(2) What monitoring does ACT Health undertake in relation to trends in the effectiveness of antibiotics used in hospitals.
(3) Has ACT Health recorded any instances of the overuse or misuse of antibiotic drugs in ACT hospitals in the last three financial years; if so, (a) how many occasions of overuse or misuse were recorded, (b) what action was taken in response and (c) what changes were made to clinical policies as a result.
(4) What is the Government’s response to the Antimicrobial Use and Resistance in Australia 2017 report, released by the Australian Commission on Safety and Quality in Health Care as it applies to health services in the ACT.
Ms Fitzharris: The answer to the member’s question is as follows:
1. ACT Health adheres to the Australian Therapeutic Guidelines: Antibiotic. Canberra and Calvary Hospitals have antibiotic restriction policies that classify antibiotics as:
• ‘green’ (no restriction on use),
• ‘orange’ (approval to be sought from antimicrobial stewardship (AMS) or infectious diseases (ID) within 72 hours of use) or
• ‘red’ (approval to be sought from AMS or ID within 24 hours of prescription).
This policy ensures specialist oversight of antibiotic use, especially antibiotics used to treat infections caused by multi-resistant organisms (MROs) or ‘superbugs’.
2. The effectiveness of antibiotics is assessed on a case by case basis at the point of prescription for each patient. The Canberra Hospital and Health Services (CHHS) Antimicrobial Stewardship team (and collaborators including the ACT Pathology Microbiology Department, CHHS Pharmacy Department and CHHS infection Control and Prevention Unit) monitors the appropriateness of antimicrobial prescribing, to enable assessment of local quality of care and to benchmark nationally. This includes where treatments are too broad or narrow, problems with allergies and antibiotics, and any therapies that are not consistent with available guidelines. ACT Health also measures and monitors the bulk usage of antibiotics in the territory on an ongoing basis to ensure continued improvement in the total usage of antibiotics.
3. Yes, which is similar to the experience in every other jurisdiction in Australia.
a) Since implementation of the current program of monitoring in August 2016, to June 2017, there were 43 instances where the advice of the anti-microbial stewardship team was not followed by treating teams for a range of clinical and logistical reasons, out of a total of 1632 reviews of restricted antibiotic prescriptions (2.5 per cent occurrence).
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