RE Prophylactic Long term Antibiotic usage in RACF

[Anonymous]

Hi all

I just have a question regarding GP s who prescribe Antibiotics “prophylactically” to minimise recurrent infections. Some have had prophylactic antibiotics prescribed for recurrent UTIs for example ( more than 4-5 in previous 12 month period)
Some of our Residents have been on Prophylactic Antibiotics for > 6 months.
Predominantly for either recurrent UTI or Respiratory Tract infections (exacerbation of COPD)
Around 50 % (sometimes higher depending on “others” prescribed) of our Monthly data statistic in regards to Antibiotics prescribed consists of those who are on ongoing “prophylactic” antibiotics

Should these Residents have a “specimen” sent to pathology for M S & C at any time to confirm whether they have become “Resistant” during the 6 months plus they have been prescribed them ?
Should a GP at minimum be reviewing this in regards to “ceasing” at any specified time ?

Kind Regards
Karen Panzich TLRN / Infection Control Coordinator
Wynyard Care Centre
Tasmania

[http://mitchmorgandesign.com/wp-content/uploads/2017/06/Logo96.jpg]
Karen Panzich
Teamleader RN
Synovum Care Group
Cnr Quiggin and Moore St, Wynyard TAS 7325
P 03 6442 1760
F 03 6442 1765

http://www.synovumcare.com.au
[http://mitchmorgandesign.com/wp-content/uploads/2017/06/FB.jpg][http://mitchmorgandesign.com/wp-content/uploads/2017/06/IN96.jpg]
[http://mitchmorgandesign.com/wp-content/uploads/2017/06/Award96.jpg]
Any views or opinions presented in this email are solely those of the author and do not necessarily represent those of the company. Employees of Synovum Care Group are expressly required not to make defamatory statements and not to infringe or authorise any infringement of copyright or any other legal right by email communications. Any such communication is contrary to company policy and outside the scope of the employment of the individual concerned. The company will not accept any liability in respect of such communication, and the employee responsible will be personally liable for any damages or other liability arising.

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[Gerald Cha]

Dear Karen,

The Australian Therapeutic Guidelines Antibiotic, has a specific section on Urinary tract infection in aged-care facility residents.

The direct link to the page is here (but you may need to pay to subscribe to the service):
https://tgldcdp.tg.org.au/viewTopic?topicfileurinary-tract-infection-aged-care#MPS_d1e129

It clearly articulates the assessment and treatment for this patient group with a helpful flowchart.

As youre aware, asymptomatic bacteriuria is very common for these patients and prophylactic antimicrobial treatment unnecessary.

I would suggest that you raise your concerns to these doctors through your IC/AMS committee (where applicable).

All the best.

Regards,

Gerald Chan CICP-E | Infection Control Manager
St John of God Murdoch Hospital
T: (08) 9428 8638 | M: | F: | E: Gerald.Chan@sjog.org.au
100 Murdoch Dve Murdoch WA 6150
http://www.sjog.org.au/murdoch | Twitter | LinkedIn | Facebook

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Hi all

I just have a question regarding GP s who prescribe Antibiotics prophylactically to minimise recurrent infections. Some have had prophylactic antibiotics prescribed for recurrent UTIs for example ( more than 4-5 in previous 12 month period)
Some of our Residents have been on Prophylactic Antibiotics for > 6 months.
Predominantly for either recurrent UTI or Respiratory Tract infections (exacerbation of COPD)
Around 50 % (sometimes higher depending on others prescribed) of our Monthly data statistic in regards to Antibiotics prescribed consists of those who are on ongoing prophylactic antibiotics

Should these Residents have a specimen sent to pathology for M S & C at any time to confirm whether they have become Resistant during the 6 months plus they have been prescribed them ?
Should a GP at minimum be reviewing this in regards to ceasing at any specified time ?

Kind Regards
Karen Panzich TLRN / Infection Control Coordinator
Wynyard Care Centre
Tasmania

[http://mitchmorgandesign.com/wp-content/uploads/2017/06/Logo96.jpg]

Karen Panzich
Teamleader RN
Synovum Care Group

Cnr Quiggin and Moore St, Wynyard TAS 7325
P 03 6442 1760
F 03 6442 1765

http://www.synovumcare.com.au

[http://mitchmorgandesign.com/wp-content/uploads/2017/06/FB.jpg][http://mitchmorgandesign.com/wp-content/uploads/2017/06/IN96.jpg]
[http://mitchmorgandesign.com/wp-content/uploads/2017/06/Award96.jpg]
Any views or opinions presented in this email are solely those of the author and do not necessarily represent those of the company. Employees of Synovum Care Group are expressly required not to make defamatory statements and not to infringe or authorise any infringement of copyright or any other legal right by email communications. Any such communication is contrary to company policy and outside the scope of the employment of the individual concerned. The company will not accept any liability in respect of such communication, and the employee responsible will be personally liable for any damages or other liability arising.

MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

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[Carrie Spinks]

Hi Karen,

I find the Australian Aged Care Home Antimicrobial Stewardship Policy a useful tool to assist with review parameters for AB prescribing in RACF:
https://irp-cdn.multiscreensite.com/d820f98f/files/uploaded/AMS%20Policy_Sept%2018.pdf

In fact I find all the NCAS (National Centre for Antimicrobial Stewardship) tools very useful.
https://www.ncas-australia.org/

Although it does not answer your first enquiry, it does your second.

Hope this is helpful.
Kind regards

Carrie

CARRIE SPINKS
Clinical Nurse Consultant Infection Control

| RSL ANZAC Village | 4 Colooli Road Narrabeen NSW 2101 | E: carrie.spinks@rsllifecare.org.au | T: 02 8978 4826 | M: 0420 940 748 | F: 02 9982 6604 | http://www.rsllifecare.org.au |

This message contains confidential information and is intended only for the individual named. If you are not the named addressee you should not disseminate,distribute or copy this e-mail.
From: ACIPC Infexion Connexion [mailto:ACIPCLIST@ACIPC.ORG.AU] On Behalf Of Team Leader RN Wynyard
Sent: Tuesday, September 10, 2019 11:13 AM
To: ACIPCLIST@ACIPC.ORG.AU
Subject: [ACIPC_Infexion_Connexion] RE Prophylactic Long term Antibiotic usage in RACF

Hi all

I just have a question regarding GP s who prescribe Antibiotics prophylactically to minimise recurrent infections. Some have had prophylactic antibiotics prescribed for recurrent UTIs for example ( more than 4-5 in previous 12 month period)
Some of our Residents have been on Prophylactic Antibiotics for > 6 months.
Predominantly for either recurrent UTI or Respiratory Tract infections (exacerbation of COPD)
Around 50 % (sometimes higher depending on others prescribed) of our Monthly data statistic in regards to Antibiotics prescribed consists of those who are on ongoing prophylactic antibiotics

Should these Residents have a specimen sent to pathology for M S & C at any time to confirm whether they have become Resistant during the 6 months plus they have been prescribed them ?
Should a GP at minimum be reviewing this in regards to ceasing at any specified time ?

Kind Regards
Karen Panzich TLRN / Infection Control Coordinator
Wynyard Care Centre
Tasmania

[http://mitchmorgandesign.com/wp-content/uploads/2017/06/Logo96.jpg]

Karen Panzich
Teamleader RN
Synovum Care Group

Cnr Quiggin and Moore St, Wynyard TAS 7325
P 03 6442 1760
F 03 6442 1765

http://www.synovumcare.com.au

[http://mitchmorgandesign.com/wp-content/uploads/2017/06/FB.jpg][http://mitchmorgandesign.com/wp-content/uploads/2017/06/IN96.jpg]
[http://mitchmorgandesign.com/wp-content/uploads/2017/06/Award96.jpg]
Any views or opinions presented in this email are solely those of the author and do not necessarily represent those of the company. Employees of Synovum Care Group are expressly required not to make defamatory statements and not to infringe or authorise any infringement of copyright or any other legal right by email communications. Any such communication is contrary to company policy and outside the scope of the employment of the individual concerned. The company will not accept any liability in respect of such communication, and the employee responsible will be personally liable for any damages or other liability arising.

______________________________________________________________________
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MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

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[Trent Yarwood]

Hi Karen,

There’s lots more information on the scale of this problem in the Aged Care
National Antimicrobial Prescribing Survey (acNAPS) – report available here:
https://www.safetyandquality.gov.au/publications-and-resources/resource-library/2017-aged-care-national-antimicrobial-prescribing-survey-report

Therapeutic Guidelines: Antibiotic has a good and pretty clear section on
indications for long-term prophylaxis for UTIs – including only if
non-antibiotic measures fail, greater than two infections in six months,
and for a defined period of time then ceasing (recommended at six months).

This is a huge potential area for quality improvement, and needs more than
just a screening urine to solve, but certainly the docs should be
collecting urine to make sure the patients don’t have resistance and
repeating them if the patient develops new clinical symptoms, but I don’t
think routine urines while patients are on therapy are the way to go.

Trent
Qld Statewide AMS Program

—
Trent Yarwood
trentyarwood@gmail.com
PGP Key: 246AF263

On Tue, 10 Sep 2019 at 11:47, Team Leader RN Wynyard wrote:

> Hi all
>
>
>
> I just have a question regarding GP s who prescribe Antibiotics
> prophylactically to minimise recurrent infections. Some have had
> prophylactic antibiotics prescribed for recurrent UTIs for example ( more
> than 4-5 in previous 12 month period)
>
> Some of our Residents have been on Prophylactic Antibiotics for > 6 months.
>
> Predominantly for either recurrent UTI or Respiratory Tract infections
> (exacerbation of COPD)
>
> Around 50 % (sometimes higher depending on others prescribed) of our
> Monthly data statistic in regards to Antibiotics prescribed consists of
> those who are on ongoing prophylactic antibiotics
>
>
>
> Should these Residents have a specimen sent to pathology for M S & C at
> any time to confirm whether they have become Resistant during the 6
> months plus they have been prescribed them ?
>
> Should a GP at minimum be reviewing this in regards to ceasing at any
> specified time ?
>
>
>
> Kind Regards
>
> Karen Panzich TLRN / Infection Control Coordinator
>
> Wynyard Care Centre
>
> Tasmania
>
>
>
>
> [image: http://mitchmorgandesign.com/wp-content/uploads/2017/06/Logo96.jpg%5D
>
>
> *Karen Panzich*
> Teamleader RN
> Synovum Care Group
>
> Cnr Quiggin and Moore St, Wynyard TAS 7325
> *P* 03 6442 1760
> *F* 03 6442 1765
>
>
> *www.synovumcare.com.au *
>
> [image: http://mitchmorgandesign.com/wp-content/uploads/2017/06/FB.jpg%5D
> [image:
> http://mitchmorgandesign.com/wp-content/uploads/2017/06/IN96.jpg%5D
>
>
> [image:
> http://mitchmorgandesign.com/wp-content/uploads/2017/06/Award96.jpg%5D
>
>
> Any views or opinions presented in this email are solely those of the
> author and do not necessarily represent those of the company. Employees of
> Synovum Care Group are expressly required not to make defamatory statements
> and not to infringe or authorise any infringement of copyright or any other
> legal right by email communications. Any such communication is contrary to
> company policy and outside the scope of the employment of the individual
> concerned. The company will not accept any liability in respect of such
> communication, and the employee responsible will be personally liable for
> any damages or other liability arising.
>
>
>
>
> MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO
> NOT REPRESENT THE OPINION OF ACIPC.
>
> The use of trade/product/commercial brand names through the list is
> discouraged by ACIPC. If you wish to discuss specific reference to products
> or services by brand or commercial names, please do this outside the list.
>
> Archive of all messages are available at http://aicalist.org.au/archives
> – registration and login required.
>
> Replies to this message will be directed back to the list. To create a new
> message send an email to acipclist@acipc.org.au
>
> To send a message to the list administrator send an email to
> admin@acipc.org.au
>
> You can unsubscribe manually from this list by sending ‘signoff acipclist’
> (without the quotes) to listserv@aicalist.org.au
>

MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

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[Anonymous]

Hi Trent
Thank you very much for the information
It appears that the GPs in question generally do make reference to the Therapeutic Guidelines and generally prescribe only once and if symptomatic and /or when all other interventions have proved unsuccessful. ( recurrent infections occur 2 or more in 6 months). I struggle to get them to review and consider ceasing once this occurs as they of the opinion that the so called infection will reoccur to the detriment of the Resident involved. It is frustrating especially when they do in part understand the requirement of responsible prescribing and generally do prescribed as per the recommended criteria but to then turn around and refuse to consider ceasing especially after 6 months and sometimes 12 months plus .. I will just have to persist.

Karen Panzich RN / IC Coordinator
Wynyard Care Centre
Tasmania

[http://mitchmorgandesign.com/wp-content/uploads/2017/06/Logo96.jpg]
Karen Panzich
Teamleader RN
Synovum Care Group
Cnr Quiggin and Moore St, Wynyard TAS 7325
P 03 6442 1760
F 03 6442 1765

http://www.synovumcare.com.au
[http://mitchmorgandesign.com/wp-content/uploads/2017/06/FB.jpg][http://mitchmorgandesign.com/wp-content/uploads/2017/06/IN96.jpg]
[http://mitchmorgandesign.com/wp-content/uploads/2017/06/Award96.jpg]
Any views or opinions presented in this email are solely those of the author and do not necessarily represent those of the company. Employees of Synovum Care Group are expressly required not to make defamatory statements and not to infringe or authorise any infringement of copyright or any other legal right by email communications. Any such communication is contrary to company policy and outside the scope of the employment of the individual concerned. The company will not accept any liability in respect of such communication, and the employee responsible will be personally liable for any damages or other liability arising.

From: ACIPC Infexion Connexion [mailto:ACIPCLIST@ACIPC.ORG.AU] On Behalf Of Trent Yarwood
Sent: Tuesday, 10 September 2019 12:55 PM
To: ACIPCLIST@ACIPC.ORG.AU
Subject: Re: [ACIPC_Infexion_Connexion] RE Prophylactic Long term Antibiotic usage in RACF

Hi Karen,

There’s lots more information on the scale of this problem in the Aged Care National Antimicrobial Prescribing Survey (acNAPS) – report available here: https://www.safetyandquality.gov.au/publications-and-resources/resource-library/2017-aged-care-national-antimicrobial-prescribing-survey-report

Therapeutic Guidelines: Antibiotic has a good and pretty clear section on indications for long-term prophylaxis for UTIs – including only if non-antibiotic measures fail, greater than two infections in six months, and for a defined period of time then ceasing (recommended at six months).

This is a huge potential area for quality improvement, and needs more than just a screening urine to solve, but certainly the docs should be collecting urine to make sure the patients don’t have resistance and repeating them if the patient develops new clinical symptoms, but I don’t think routine urines while patients are on therapy are the way to go.

Trent
Qld Statewide AMS Program

—
Trent Yarwood
trentyarwood@gmail.com
PGP Key: 246AF263

On Tue, 10 Sep 2019 at 11:47, Team Leader RN Wynyard <TeamLeaderRNWynyard@synovumcare.com.au> wrote:
Hi all

I just have a question regarding GP s who prescribe Antibiotics prophylactically to minimise recurrent infections. Some have had prophylactic antibiotics prescribed for recurrent UTIs for example ( more than 4-5 in previous 12 month period)
Some of our Residents have been on Prophylactic Antibiotics for > 6 months.
Predominantly for either recurrent UTI or Respiratory Tract infections (exacerbation of COPD)
Around 50 % (sometimes higher depending on others prescribed) of our Monthly data statistic in regards to Antibiotics prescribed consists of those who are on ongoing prophylactic antibiotics

Should these Residents have a specimen sent to pathology for M S & C at any time to confirm whether they have become Resistant during the 6 months plus they have been prescribed them ?
Should a GP at minimum be reviewing this in regards to ceasing at any specified time ?

Kind Regards
Karen Panzich TLRN / Infection Control Coordinator
Wynyard Care Centre
Tasmania

Karen Panzich
Teamleader RN
Synovum Care Group
Cnr Quiggin and Moore St, Wynyard TAS 7325
P 03 6442 1760
F 03 6442 1765

http://www.synovumcare.com.au

Any views or opinions presented in this email are solely those of the author and do not necessarily represent those of the company. Employees of Synovum Care Group are expressly required not to make defamatory statements and not to infringe or authorise any infringement of copyright or any other legal right by email communications. Any such communication is contrary to company policy and outside the scope of the employment of the individual concerned. The company will not accept any liability in respect of such communication, and the employee responsible will be personally liable for any damages or other liability arising.

MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.

Archive of all messages are available at http://aicalist.org.au/archives – registration and login required.

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The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.

Archive of all messages are available at http://aicalist.org.au/archives – registration and login required.

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The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.

Archive of all messages are available at http://aicalist.org.au/archives – registration and login required.

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[Anonymous]

Hi Carrie

Thank you for assistance with this. The links supplied are helpful and validate in part what I struggle to get across to some of our visiting GPs.

Kind Regards
Karen Panzich TLRN / IC Coordinator
Wynyard Care Centre
Tasmania

[http://mitchmorgandesign.com/wp-content/uploads/2017/06/Logo96.jpg]
Karen Panzich
Teamleader RN
Synovum Care Group
Cnr Quiggin and Moore St, Wynyard TAS 7325
P 03 6442 1760
F 03 6442 1765

http://www.synovumcare.com.au
[http://mitchmorgandesign.com/wp-content/uploads/2017/06/FB.jpg][http://mitchmorgandesign.com/wp-content/uploads/2017/06/IN96.jpg]
[http://mitchmorgandesign.com/wp-content/uploads/2017/06/Award96.jpg]
Any views or opinions presented in this email are solely those of the author and do not necessarily represent those of the company. Employees of Synovum Care Group are expressly required not to make defamatory statements and not to infringe or authorise any infringement of copyright or any other legal right by email communications. Any such communication is contrary to company policy and outside the scope of the employment of the individual concerned. The company will not accept any liability in respect of such communication, and the employee responsible will be personally liable for any damages or other liability arising.

From: ACIPC Infexion Connexion [mailto:ACIPCLIST@ACIPC.ORG.AU] On Behalf Of Carrie Spinks
Sent: Tuesday, 10 September 2019 12:28 PM
To: ACIPCLIST@ACIPC.ORG.AU
Subject: Re: [ACIPC_Infexion_Connexion] RE Prophylactic Long term Antibiotic usage in RACF

Hi Karen,

I find the Australian Aged Care Home Antimicrobial Stewardship Policy a useful tool to assist with review parameters for AB prescribing in RACF:
https://irp-cdn.multiscreensite.com/d820f98f/files/uploaded/AMS%20Policy_Sept%2018.pdf

In fact I find all the NCAS (National Centre for Antimicrobial Stewardship) tools very useful.
https://www.ncas-australia.org/

Although it does not answer your first enquiry, it does your second.

Hope this is helpful.
Kind regards

Carrie

CARRIE SPINKS
Clinical Nurse Consultant Infection Control

| RSL ANZAC Village | 4 Colooli Road Narrabeen NSW 2101 | E: carrie.spinks@rsllifecare.org.au | T: 02 8978 4826 | M: 0420 940 748 | F: 02 9982 6604 | http://www.rsllifecare.org.au |

This message contains confidential information and is intended only for the individual named. If you are not the named addressee you should not disseminate,distribute or copy this e-mail.
From: ACIPC Infexion Connexion [mailto:ACIPCLIST@ACIPC.ORG.AU] On Behalf Of Team Leader RN Wynyard
Sent: Tuesday, September 10, 2019 11:13 AM
To: ACIPCLIST@ACIPC.ORG.AU
Subject: [ACIPC_Infexion_Connexion] RE Prophylactic Long term Antibiotic usage in RACF

Hi all

I just have a question regarding GP s who prescribe Antibiotics prophylactically to minimise recurrent infections. Some have had prophylactic antibiotics prescribed for recurrent UTIs for example ( more than 4-5 in previous 12 month period)
Some of our Residents have been on Prophylactic Antibiotics for > 6 months.
Predominantly for either recurrent UTI or Respiratory Tract infections (exacerbation of COPD)
Around 50 % (sometimes higher depending on others prescribed) of our Monthly data statistic in regards to Antibiotics prescribed consists of those who are on ongoing prophylactic antibiotics

Should these Residents have a specimen sent to pathology for M S & C at any time to confirm whether they have become Resistant during the 6 months plus they have been prescribed them ?
Should a GP at minimum be reviewing this in regards to ceasing at any specified time ?

Kind Regards
Karen Panzich TLRN / Infection Control Coordinator
Wynyard Care Centre
Tasmania

[http://mitchmorgandesign.com/wp-content/uploads/2017/06/Logo96.jpg]
Karen Panzich
Teamleader RN
Synovum Care Group
Cnr Quiggin and Moore St, Wynyard TAS 7325
P 03 6442 1760
F 03 6442 1765

http://www.synovumcare.com.au
[http://mitchmorgandesign.com/wp-content/uploads/2017/06/FB.jpg][http://mitchmorgandesign.com/wp-content/uploads/2017/06/IN96.jpg]
[http://mitchmorgandesign.com/wp-content/uploads/2017/06/Award96.jpg]
Any views or opinions presented in this email are solely those of the author and do not necessarily represent those of the company. Employees of Synovum Care Group are expressly required not to make defamatory statements and not to infringe or authorise any infringement of copyright or any other legal right by email communications. Any such communication is contrary to company policy and outside the scope of the employment of the individual concerned. The company will not accept any liability in respect of such communication, and the employee responsible will be personally liable for any damages or other liability arising.

______________________________________________________________________
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[karenbooth1@BIGPOND.COM Subject: Re: RE Prophylactic Long term Antibiotic usage in RACF MIME-Version: 1.0 Content-Type: multipart/alternative; boundary=”—-=_NextPart_001_065A_01D56E53.BC210840″ Message-ID:]

HI all,

FYI in this weeks NPS RADAR news letter

Antibiotic prescribing in primary care: Therapeutic Guidelines summary table:

https://tgldcdp.tg.org.au/fulltext/quicklinks/GPSummary_v11.pdf?_cldeea2FyZW5ib290aDFAYmlncG9uZC5jb20%3d &recipientidcontact-ea40f490a34fe511943b0050568a45a5-896873b2a60a42b1908c71097c94a502&esid64de5f10-c6d5-e911-94ae-0050568a45a5

cheers

Karen

Karen Booth

RN BHSCN GAICD

President APNA

Australian Primary Health Care Nurses Association

M: 0411 898 884

karenbooth1@bigpond.com

Australian Primary Health Care Nurses Association (APNA)
Level 17/350 Queen Street, Melbourne VIC 3000
p: 1300 303 184 f: (03) 9322 9599
president@apna.asn.au | http://www.apna.asn.au

Hi Karen,

Most GPs are well aware of the guidelines. It is a common topic in GP medical weekly magazines but they succumb to habit and pressure from families and RACFs where they routinely test asymptomatic patients and send off urines for MCS. I work in general practice and take calls from RACFs regularly. More work needs to be done to assist RACF in better understanding of AMR and prescribing antibiotics for asymptomatic patients and protocols re testing of same. Some female patients would benefit from topical oestrogen as a preventative but this is not commonly discussed for elderly women. I know ACIPC is running aged care IPC workshops.

The commonwealth Chief Medical Officer writes to GPs and antibiotic prescribing is often a target of his messages.

Kind regards

Karen

Karen Booth

RN BHSCN GAICD

President APNA

Australian Primary Health Care Nurses Association

M: 0411 898 884

karenbooth1@bigpond.com

Australian Primary Health Care Nurses Association (APNA)
Level 17/350 Queen Street, Melbourne VIC 3000
p: 1300 303 184 f: (03) 9322 9599
president@apna.asn.au | http://www.apna.asn.au

Hi Trent

Thank you very much for the information

It appears that the GPs in question generally do make reference to the Therapeutic Guidelines and generally prescribe only once and if symptomatic and /or when all other interventions have proved unsuccessful. ( recurrent infections occur 2 or more in 6 months). I struggle to get them to review and consider ceasing once this occurs as they of the opinion that the so called infection will reoccur to the detriment of the Resident involved. It is frustrating especially when they do in part understand the requirement of responsible prescribing and generally do prescribed as per the recommended criteria but to then turn around and refuse to consider ceasing especially after 6 months and sometimes 12 months plus .. I will just have to persist.

Karen Panzich RN / IC Coordinator

Wynyard Care Centre

Tasmania

Karen Panzich
Teamleader RN
Synovum Care Group

Cnr Quiggin and Moore St, Wynyard TAS 7325
P 03 6442 1760
F 03 6442 1765

http://www.synovumcare.com.au

Any views or opinions presented in this email are solely those of the author and do not necessarily represent those of the company. Employees of Synovum Care Group are expressly required not to make defamatory statements and not to infringe or authorise any infringement of copyright or any other legal right by email communications. Any such communication is contrary to company policy and outside the scope of the employment of the individual concerned. The company will not accept any liability in respect of such communication, and the employee responsible will be personally liable for any damages or other liability arising.

Hi Karen,

There’s lots more information on the scale of this problem in the Aged Care National Antimicrobial Prescribing Survey (acNAPS) – report available here: https://www.safetyandquality.gov.au/publications-and-resources/resource-library/2017-aged-care-national-antimicrobial-prescribing-survey-report

Therapeutic Guidelines: Antibiotic has a good and pretty clear section on indications for long-term prophylaxis for UTIs – including only if non-antibiotic measures fail, greater than two infections in six months, and for a defined period of time then ceasing (recommended at six months).

This is a huge potential area for quality improvement, and needs more than just a screening urine to solve, but certainly the docs should be collecting urine to make sure the patients don’t have resistance and repeating them if the patient develops new clinical symptoms, but I don’t think routine urines while patients are on therapy are the way to go.

Trent

Qld Statewide AMS Program

—
Trent Yarwood
trentyarwood@gmail.com

PGP Key: 246AF263

On Tue, 10 Sep 2019 at 11:47, Team Leader RN Wynyard <TeamLeaderRNWynyard@synovumcare.com.au > wrote:

Hi all

I just have a question regarding GP s who prescribe Antibiotics prophylactically to minimise recurrent infections. Some have had prophylactic antibiotics prescribed for recurrent UTIs for example ( more than 4-5 in previous 12 month period)

Some of our Residents have been on Prophylactic Antibiotics for > 6 months.

Predominantly for either recurrent UTI or Respiratory Tract infections (exacerbation of COPD)

Around 50 % (sometimes higher depending on others prescribed) of our Monthly data statistic in regards to Antibiotics prescribed consists of those who are on ongoing prophylactic antibiotics

Should these Residents have a specimen sent to pathology for M S & C at any time to confirm whether they have become Resistant during the 6 months plus they have been prescribed them ?

Should a GP at minimum be reviewing this in regards to ceasing at any specified time ?

Kind Regards

Karen Panzich TLRN / Infection Control Coordinator

Wynyard Care Centre

Tasmania

Karen Panzich
Teamleader RN
Synovum Care Group

Cnr Quiggin and Moore St, Wynyard TAS 7325
P 03 6442 1760
F 03 6442 1765

http://www.synovumcare.com.au

Any views or opinions presented in this email are solely those of the author and do not necessarily represent those of the company. Employees of Synovum Care Group are expressly required not to make defamatory statements and not to infringe or authorise any infringement of copyright or any other legal right by email communications. Any such communication is contrary to company policy and outside the scope of the employment of the individual concerned. The company will not accept any liability in respect of such communication, and the employee responsible will be personally liable for any damages or other liability arising.

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