{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T11:10:03Z","timestamp":1768821003257,"version":"3.49.0"},"reference-count":24,"publisher":"Cambridge University Press (CUP)","issue":"1","license":[{"start":{"date-parts":[[2025,1,17]],"date-time":"2025-01-17T00:00:00Z","timestamp":1737072000000},"content-version":"unspecified","delay-in-days":16,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ASHE"],"published-print":{"date-parts":[[2025]]},"abstract":"<jats:title>Abstract<\/jats:title>\n\t  <jats:sec id=\"S2732494X24004832_as1\">\n\t    <jats:title>Objective:<\/jats:title>\n\t    <jats:p>To analyze antimicrobial prescribing practices in Australian emergency departments (ED), identifying prescribing areas requiring improvement. This aims to inform antimicrobial stewardship (AMS) strategies to enhance antimicrobial prescribing quality.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2732494X24004832_as2\">\n\t    <jats:title>Design<\/jats:title>\n\t    <jats:p>Retrospective analysis of the Hospital National Antimicrobial Prescribing Survey (NAPS) data set.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2732494X24004832_as3\">\n\t    <jats:title>Setting<\/jats:title>\n\t    <jats:p>EDs in public and private Australian hospitals (n = 652).<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2732494X24004832_as4\">\n\t    <jats:title>Participants<\/jats:title>\n\t    <jats:p>Hospitals (n = 652) that participated in the Hospital NAPS from 2013 to 2022.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2732494X24004832_as5\">\n\t    <jats:title>Methods<\/jats:title>\n\t    <jats:p>Data were collected by trained auditors from participating hospitals with the use of a standardized auditing tool, the Hospital NAPS. Data from 2013 to 2022 were analyzed descriptively. Variables assessed included guideline compliance and appropriateness by antimicrobial and indication, and reasons for inappropriateness.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2732494X24004832_as6\">\n\t    <jats:title>Results<\/jats:title>\n\t    <jats:p>There were 3,098 antimicrobial prescriptions from EDs included for analysis. Guideline compliance (63.5%) and appropriateness (70.4%) in EDs were lower compared to overall prescribing practices from all departments. The most commonly prescribed antimicrobial was ceftriaxone (16.9%, n = 523), and the most common indication was empiric prescribing for community-acquired pneumonia (16.0%, n = 497). Amoxicillin-clavulanic acid (53.2%, n = 99), and acute exacerbation of chronic obstructive pulmonary disease (54.3%, n = 57), were the antimicrobial and indication with the lowest rates of appropriateness respectively. Ceftriaxone prescribing also had a low rate of appropriateness (62.3%, n = 326). Selection of antimicrobials with too broad of a spectrum was the most common reason for inappropriateness (40.2%).<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2732494X24004832_as7\">\n\t    <jats:title>Conclusion<\/jats:title>\n\t    <jats:p>Antimicrobial prescribing quality in EDs warrants improvement. Recommended targets for AMS interventions are the excessive and inappropriate use of broad-spectrum antimicrobials such as ceftriaxone and amoxicillin-clavulanic acid in common respiratory and urinary tract infections.<\/jats:p>\n\t  <\/jats:sec>","DOI":"10.1017\/ash.2024.483","type":"journal-article","created":{"date-parts":[[2025,1,17]],"date-time":"2025-01-17T07:16:31Z","timestamp":1737098191000},"source":"Crossref","is-referenced-by-count":3,"title":["Antimicrobial prescribing quality in Australian emergency departments: an analysis of the Hospital NAPS data set"],"prefix":"10.1017","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-8220-0554","authenticated-orcid":false,"given":"Lenna","family":"Zosky-Shiller","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7400-232X","authenticated-orcid":false,"given":"Karin","family":"Thursky","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6579-9979","authenticated-orcid":false,"given":"Sarah","family":"Park","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1425-029X","authenticated-orcid":false,"given":"Rodney","family":"James","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9309-9315","authenticated-orcid":false,"given":"Lisa","family":"Hall","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9512-0448","authenticated-orcid":false,"given":"Caroline","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5472-8895","authenticated-orcid":false,"given":"Courtney","family":"Ierano","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2025,1,17]]},"reference":[{"key":"S2732494X24004832_ref19","doi-asserted-by":"publisher","DOI":"10.1086\/666331"},{"key":"S2732494X24004832_ref4","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(18)30060-4"},{"key":"S2732494X24004832_ref12","unstructured":"12. Priority Antibacterial List for Antimicrobial Resistance Containment. Australian Commission on Safety and Quality in Healthcare website. https:\/\/www.safetyandquality.gov.au\/publications-and-resources\/resource-library\/priority-antibacterial-list-antimicrobial-resistance-containment. Published 2020. Accessed August 9, 2023."},{"key":"S2732494X24004832_ref7","doi-asserted-by":"publisher","DOI":"10.1111\/1742-6723.12346"},{"key":"S2732494X24004832_ref13","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dky447"},{"key":"S2732494X24004832_ref18","doi-asserted-by":"publisher","DOI":"10.1111\/1742-6723.12326"},{"key":"S2732494X24004832_ref22","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2012.09.002"},{"key":"S2732494X24004832_ref10","unstructured":"10. Therapeutic Guidelines website. https:\/\/www.tg.org.au\/. Published 2023. Accessed August 9, 2023."},{"key":"S2732494X24004832_ref23","doi-asserted-by":"publisher","DOI":"10.1177\/1060028017709820"},{"key":"S2732494X24004832_ref3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jemermed.2016.12.009"},{"key":"S2732494X24004832_ref2","first-page":"629","article-title":"Global mortality associated with 33 bacterial pathogens in 2019: a systematic analysis for the Global Burden of Disease Study 2019","volume":"399","author":"Ikuta","year":"2022","journal-title":"Lancet"},{"key":"S2732494X24004832_ref9","unstructured":"9. Rural & Remote Australians. Australian Institute of Health and Welfare website. https:\/\/www.aihw.gov.au\/reports-data\/population-groups\/rural-remote-australians\/overview. Published 2022. Accessed August 15, 2023."},{"key":"S2732494X24004832_ref6","unstructured":"6. Interagency Coordination Group on Antimicrobial Resistance, No time to Wait: Securing the future from drug-resistant infections. World Health Organization website. https:\/\/www.who.int\/publications\/i\/item\/no-time-to-wait-securing-the-future-from-drug-resistant-infections. Published 2019. Accessed July 31, 2023"},{"key":"S2732494X24004832_ref8","doi-asserted-by":"publisher","DOI":"10.1086\/677637"},{"key":"S2732494X24004832_ref14","doi-asserted-by":"publisher","DOI":"10.1177\/8755122517720293"},{"key":"S2732494X24004832_ref5","unstructured":"5. Antimicrobial Resistance. World Health Organization website. https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/antimicrobial-resistance. Published 2021. Accessed July 31, 2023"},{"key":"S2732494X24004832_ref16","doi-asserted-by":"publisher","DOI":"10.1177\/0897190020953032"},{"key":"S2732494X24004832_ref17","doi-asserted-by":"publisher","DOI":"10.1007\/s11096-021-01255-w"},{"key":"S2732494X24004832_ref24","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2020.10.028"},{"key":"S2732494X24004832_ref11","unstructured":"11. Antimicrobial Prescribing Practice in Australian Hospitals \u2013 Results of the 2020 Hospital National Antimicrobial Prescribing Survey. Australian Government website. https:\/\/www.amr.gov.au\/resources\/antimicrobial-prescribing-practice-australian-hospitals-results-2020-hospital-national-antimicrobial-prescribing-survey. Published 2023. Accessed September 14, 2023."},{"key":"S2732494X24004832_ref15","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-018-3339-y"},{"key":"S2732494X24004832_ref21","unstructured":"21. Info for Clinicians \u2013 Antimicrobial Stewardship Clinical Care Standard. Australian Commission on Safety and Quality in Healthcare website. https:\/\/www.safetyandquality.gov.au\/our-work\/clinical-care-standards\/antimicrobial-stewardship-clinical-care-standard\/info-clinicians. Published 2020. Accessed September 5, 2023."},{"key":"S2732494X24004832_ref1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.13836"},{"key":"S2732494X24004832_ref20","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00473-17"}],"container-title":["Antimicrobial Stewardship &amp; Healthcare Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S2732494X24004832","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,17]],"date-time":"2025-01-17T07:16:36Z","timestamp":1737098196000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S2732494X24004832\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025]]},"references-count":24,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025]]}},"alternative-id":["S2732494X24004832"],"URL":"https:\/\/doi.org\/10.1017\/ash.2024.483","relation":{},"ISSN":["2732-494X"],"issn-type":[{"value":"2732-494X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025]]},"article-number":"e9"}}