ORCID Profile
0000-0003-0523-9080
Current Organisations
Australian Commission on Safety and Quality in Health Care
,
University of Sydney
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Publications
Invasive Candidiasis in the Elderly: Considerations for Drug Therapy
Publisher: Springer Science and Business Media LLC
Date: 26-07-2018
Building on Antimicrobial Stewardship Programs Through Integration with Electronic Medical Records: The Australian Experience
Publisher: Springer Science and Business Media LLC
Date: 11-01-2021
Practising refraction in ophthalmology: instructive or outdated? A prospective study and literature review
Publisher: Informa UK Limited
Date: 03-02-2023
Hospital antibiotic prescribing patterns in adult patients according to the WHO Access, Watch and Reserve classification (AWaRe): results from a worldwide point prevalence survey in 69 countries
Publisher: Oxford University Press (OUP)
Date: 05-04-2021
DOI: 10.1093/JAC/DKAB050
Abstract: The WHO Access, Watch and Reserve (AWaRe) classification has been developed to support countries and hospitals in promoting rational use of antibiotics while improving access to these essential medicines. We aimed to describe patterns of worldwide antibiotic use according to the AWaRe classification in the adult inpatient population. The Global Point Prevalence Survey on Antimicrobial Consumption and Resistance (Global-PPS) collects hospital antibiotic use data using a standardized PPS methodology. Global-PPS 2015, 2017 and 2018 data, collected by 664 hospitals in 69 countries, were categorized into AWaRe groups to calculate proportional AWaRe use, Access-to-Watch ratios and the most common indications for treatment with selected Watch antibiotics. Only prescriptions for systemic antibiotics on adult inpatient wards were analysed. Regional Access use ranged from 28.4% in West and Central Asia to 57.7% in Oceania, whereas Watch use was lowest in Oceania (41.3%) and highest in West and Central Asia (66.1%). Reserve use ranged from 0.03% in sub-Saharan Africa to 4.7% in Latin America. There were large differences in AWaRe prescribing at country level. Watch antibiotics were prescribed for a range of very different indications worldwide, both for therapeutic and prophylactic use. We observed considerable variations in AWaRe prescribing and high use of Watch antibiotics, particularly in lower- and upper-middle-income countries, followed by high-income countries. The WHO AWaRe classification has an instrumental role to play in local and national stewardship activities to assess prescribing patterns and to inform and evaluate stewardship activities.
Antimicrobial stewardship audit and feedback rounds: the impact of electronic systems and moving beyond the restricted antibiotic list
Publisher: Wiley
Date: 23-10-2021
DOI: 10.1111/IMJ.14979
Abstract: Current methods of antimicrobial usage surveillance have limited efficacy in changing practice due to delayed reporting to clinicians and the inability to stratify by medical specialty. This study was undertaken in a tertiary teaching hospital with a well established antimicrobial stewardship (AMS) programme and electronic medicines management (eMM) system in Sydney, Australia. To describe and analyse the implementation of a novel AMS audit and feedback method, in the context of an eMM system. The AMS team conducted the audit weekly, and the study design was a prospective, observational study. All acute, adult inpatients were included in this intervention. All active systemic antimicrobial prescriptions on the day of the rounds were included. The prevalence of patients on antimicrobial therapy was 37%. The median time taken per round was 44 min for eMM compared to 58 min for paper. All key performance indicators improved over the study period. Appropriateness compared to guidelines increased from 55% to 71%, and documentation of an indication increased from 75% to 98%. There were 1413 recommendations made, with the most common being to cease an antimicrobial agent. The recommendation uptake rate was 47% at 24 h post‐round. AMS rounds are an effective tool for auditing and providing feedback on antimicrobial use and should include all antimicrobials rather than solely ‘restricted’ agents. These rounds had a high uptake rate, improvements in the appropriateness of antimicrobial use, and a planned duration or review date. A benefit of eMM was improvement in the documentation of indication for antimicrobial agents, and reduced time taken to audit.
Building on Antimicrobial Stewardship Programs Through Integration with Electronic Medical Records: The Australian Experience
Publisher: Adis Journals
Date: 2021
Related Organisations
Australian Commission On Safety And Quality In Health Care
Location: Australia
Related Funding Activities
No related grants have been discovered for Fiona Doukas.