{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T16:04:09Z","timestamp":1751472249901,"version":"3.40.5"},"reference-count":17,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,3,20]],"date-time":"2023-03-20T00:00:00Z","timestamp":1679270400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Australian J Rural Health"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>The aim of this study was to investigate the type, indication and duration of restricted antibiotics prescribed to inpatients who had undergone antimicrobial stewardship (AMS) review by the infectious diseases specialist and to assess the effectiveness of the AMS program in a rural hospital.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>This was an observational retrospective study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>The study was conducted at a rural referral hospital in NSW.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>Inpatients from the medical, surgical and intensive care units were included.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Outcome Measures<\/jats:title><jats:p>The main outcome measure was the type, indication and average duration of restricted antibiotics that were reviewed in the AMS rounds. The rate of adherence to AMS advice and the rate of step\u2010down of antibiotics after AMS advice were other outcome measures. Data on participant characteristics were also collected.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The most commonly prescribed restricted antibiotic in medicine and surgery was amoxicillin\u2013clavulanic acid (28%), followed by ceftriaxone (15%) and piperacillin\u2013tazobactam (10%), with the most common indication being intra\u2010abdominal infection (37%). In intensive care, ceftriaxone (16.7%) and piperacillin\u2013tazobactam (16.7%) were most prescribed, and the most common indication was community\u2010acquired pneumonia (24.5%). The adherence rate to AMS advice was 86% in medicine and surgery and 83% in intensive care. AMS rounds managed to cease or step down antibiotics 60% of the time.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The AMS program in a rural hospital was effective with an overall AMS advice adherence rate of 84.5% which measures well against tertiary\u2010level centres. Continued AMS and advocacy of such programs in rural regions are fundamental to optimising patient outcomes in the rural community.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajr.12979","type":"journal-article","created":{"date-parts":[[2023,3,20]],"date-time":"2023-03-20T13:23:32Z","timestamp":1679318612000},"page":"522-531","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["The effectiveness of an antimicrobial stewardship program in an Australian rural hospital"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2006-1914","authenticated-orcid":false,"given":"Melissa","family":"Park","sequence":"first","affiliation":[{"name":"The College of Health, Medicine and Wellbeing The University of Newcastle  Taree New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Devin","family":"Deo","sequence":"additional","affiliation":[{"name":"Manning Base Hospital  Taree New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shih Pui Peony","family":"Tan","sequence":"additional","affiliation":[{"name":"Manning Base Hospital  Taree New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nazli","family":"Bahtigur","sequence":"additional","affiliation":[{"name":"The College of Health, Medicine and Wellbeing The University of Newcastle  Taree New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nilar","family":"Lwin","sequence":"additional","affiliation":[{"name":"The College of Health, Medicine and Wellbeing The University of Newcastle  Taree New South Wales Australia"},{"name":"Manning Base Hospital  Taree New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,3,20]]},"reference":[{"doi-asserted-by":"publisher","key":"e_1_2_12_2_1","DOI":"10.1086\/510393"},{"unstructured":"The Clinical Excellence Commission [Internet].NSW health: CEC. Antimicrobial stewardship. [cited 2021 April 12]. Available from:https:\/\/www.cec.health.nsw.gov.au\/keep\u2010patients\u2010safe\/medication\u2010safety\/antimicrobial\u2010stewardship","key":"e_1_2_12_3_1"},{"doi-asserted-by":"publisher","key":"e_1_2_12_4_1","DOI":"10.5694\/mja2.50218"},{"volume-title":"Third Australian report on antimicrobial use and resistance in human health. [Internet]","year":"2019","author":"Australian Commission on Safety and Quality in Health Care","key":"e_1_2_12_5_1"},{"doi-asserted-by":"publisher","key":"e_1_2_12_6_1","DOI":"10.1093\/jac\/dkv047"},{"unstructured":"Australian Commission on Safety and Quality in Health Care [Internet].Sydney: ACSQHC. Safety and quality improvement guide standard 3: Preventing and controlling healthcare associated infections.2012[cited 2021 Aug 8]. Available from:http:\/\/www.safetyandquality.gov.au\/wp\u2010content\/uploads\/2011\/09\/NSQHS\u2010Standards\u2010Sept\u20102012.pdf","key":"e_1_2_12_7_1"},{"doi-asserted-by":"publisher","key":"e_1_2_12_8_1","DOI":"10.1071\/AH19097"},{"doi-asserted-by":"publisher","key":"e_1_2_12_9_1","DOI":"10.3389\/fpubh.2020.493904"},{"doi-asserted-by":"publisher","key":"e_1_2_12_10_1","DOI":"10.22605\/RRH4442"},{"doi-asserted-by":"publisher","key":"e_1_2_12_11_1","DOI":"10.1093\/jac\/dkv159"},{"volume-title":"Antimicrobial prescribing practice in Australian hospitals results of the 2019 hospital National Antimicrobial Prescribing Survey","year":"2021","author":"National Centre for Antimicrobial Stewardship and Australian Commission on Safety and Quality in Health Care [Internet]","key":"e_1_2_12_12_1"},{"unstructured":"The Clinical Excellence Commission [Internet].NSW health: CEC. The 5\u00d75 antimicrobial audit audit user guide.2021[cited 2021 Aug 11]. Available from:https:\/\/www.cec.health.nsw.gov.au\/__data\/assets\/pdf_file\/0003\/258717\/5x5\u2010Antimicrobial\u2010Audit\u2010User\u2010Guide.pdf","key":"e_1_2_12_13_1"},{"unstructured":"District Antimicrobial Restriction List Management [Internet].Hunter New England Local Health District: NSW Health.2019[cited 2021 Oct 01]. 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