Appendix 5 Hospital NAPS definitions of appropriateness Appropriateness If endorsed guidelines are present If endorsed guidelines are absent The antimicrobial prescription has been reviewed and endorsed by a clinician with expert antimicrobial prescribing knowledge.4 Antimicrobial prescription follows either the Therapeutic Guidelines2 or endorsed local guidelines optimally, including OR 1 Optimal1 antimicrobial choice, dosage, route and duration3, (including for The prescribed antimicrobial will cover the likely causative OR cultured pathogens and there is not a surgical prophylaxis) narrower spectrum or more appropriate antimicrobial choice, dosage, route or duration3 available, (including for surgical prophylaxis) Appropriate Antimicrobial prescription does not optimally follow the Therapeutic Guidelines2 or endorsed local guidelines, including antimicrobial Antimicrobial prescription including antimicrobial choice, dosage, and duration3 is not the most choice, dosage, route or duration3, however, is a reasonable optimal, however, is a reasonable alternative choice for the likely causative or cultured pathogens alternative choice for the likely causative or cultured pathogens 2 Adequate OR OR For surgical prophylaxis, as above and duration3 is less than 24 hours For surgical prophylaxis, as above and duration3 is less than 24 hours Antimicrobial prescription including antimicrobial choice, dosage, route and duration3, is an unreasonable choice for the likely causative or cultured pathogens, including: spectrum excessively or an unnecessary overlap in spectrum of activity failure to appropriately de-escalate with microbiological results 3 Suboptimal OR There may be a mild or non-life-threatening allergy mismatch Inappropriate Antimicrobial prescription including antimicrobial choice , dosage, route or duration3 is unlikely to treat the likely causative or cultured pathogens OR An antimicrobial is not indicated for the documented or presumed indication 4 Inadequate OR There may be a severe or possibly life-threatening allergy mismatch, or the potential risk of toxicity due to drug interaction OR For surgical prophylaxis, the duration3 is greater than 24 (except where guidelines endorse this)
Appendix 5 Hospital NAPS definitions of appropriateness Appropriateness If endorsed guidelines are present If endorsed guidelines are absent Appropriate 1 Optimal1 Antimicrobial prescription follows either the Therapeutic Guidelines2 or endorsed local guidelines optimally, including antimicrobial choice, dosage, route and duration3, (including for surgical prophylaxis) The antimicrobial prescription has been reviewed and endorsed by a clinician with expert antimicrobial prescribing knowledge.4 OR The prescribed antimicrobial will cover the likely causative OR cultured pathogens and there is not a narrower spectrum or more appropriate antimicrobial choice, dosage, route or duration3 available, (including for surgical prophylaxis) 2 Adequate Antimicrobial prescription does not optimally follow the Therapeutic Guidelines2 or endorsed local guidelines, including antimicrobial choice, dosage, route or duration3, however, is a reasonable alternative choice for the likely causative or cultured pathogens OR For surgical prophylaxis, as above and duration3 is less than 24 hours Antimicrobial prescription including antimicrobial choice, dosage, and duration3 is not the most optimal, however, is a reasonable alternative choice for the likely causative or cultured pathogens OR For surgical prophylaxis, as above and duration3 is less than 24 hours Inappropriate 3 Suboptimal Antimicrobial prescription including antimicrobial choice, dosage, route and duration3, is an unreasonable choice for the likely causative or cultured pathogens, including: spectrum excessively or an unnecessary overlap in spectrum of activity failure to appropriately de-escalate with microbiological results OR There may be a mild or non-life-threatening allergy mismatch 4 Inadequate Antimicrobial prescription including antimicrobial choice , dosage, route or duration3 is unlikely to treat the likely causative or cultured pathogens OR An antimicrobial is not indicated for the documented or presumed indication OR There may be a severe or possibly life-threatening allergy mismatch, or the potential risk of toxicity due to drug interaction OR For surgical prophylaxis, the duration3 is greater than 24 (except where guidelines endorse this)
Antimicrobial-prescribing-practice-in-Australian-hospitals-Results-of-the-2015-National-Antimicrobial-Prescribing-Survey.docx