Serial Point‐Prevalence Studies to Investigate Hospital Antimicrobial Prescribing

ABSTRACT Aim To investigate antimicrobial prescribing patterns using a validated point‐prevalence approach and to identify intervention targets to optimise antimicrobial use. Method 3 prospective point‐prevalence studies were conducted over 4‐day periods in April 2005, September 2005 and April 2006 at a tertiary hospital using a previously published method. Clinical pharmacists used a standardised data collection form on an allocated day to record details of all patients who were prescribed systemic antimicrobials (antivirals, antifungals, antibacterials) and the total number of patients seen. The appropriateness of the IV route was assessed using pre‐defined criteria. Results Over the 3 study periods 1515 drug charts were reviewed. Of these, 508 (34%) patients were prescribed 832 antimicrobial courses. The mean patient age was 67.5 (SD 32.3) years and 55% were males. Treatment accounted for 730 (88%) courses and prophylaxis for 102 (12%). The most frequently prescribed antimicrobials were ceftriaxone (9.7%) and amoxycillin/clavulanate (7.5%). The most commonly prescribed antimicrobial classes were penicillins (26%) and cephalosporins (20%). 342 (41%) courses were restricted antimicrobials and 85% of these had appropriate approval. 478 (58%) courses were given IV with clinical pharmacists identifying that 2.9% of these could have been given orally. Conclusion Serial point‐prevalence studies proved to be an effective tool for examining baseline patterns of antimicrobial use. This efficient and reproducible tool would be appropriate for other hospitals to use as a component of their antimicrobial usage monitoring.