Nizam Damani, Michael Mulhern.
An audit to determine the level and appropriateness of antibiotic prescribing at a district general hospital.
Infect Dis J Jan ;16(2):33-4.

We determined the level and appropriateness of prescription of antimicrobial agents, as recommended in the Northern Ireland Antimicrobial Resistance Action Plan 2002-05, auditing prescriptions by means of a point prevalence study. On the day of audit there were 266 inpatients, 90 (33.8%) patients were on antibiotic therapy. 82 (91.1%) patients were on antibiotics for treatment of infection, 8 (8.9%) patients were on prophylactic antibiotics. In 61 (68%) cases the reason justifying antibiotics was stated in the patients notes. 19 (18%) patients were documented as having an allergy to at least one antibiotic. The most common diagnosis was chest infection (35 cases), followed by urinary tract infection (21 cases). The most frequently prescribed antibiotics were amoxicillin (20 patients) and clarithromycin (21 patients). 38 (42%) of prescriptions were deemed to be in accordance with local guidelines. 25 (28%) of the infections were confirmed by microbiological investigation. The audit showed appropriate antibiotic prescription in the majority of cases although significant deficiencies were noted in other areas. These results highlight the need for ongoing antibiotic audit which in future could be performed in conjunction with antimicrobial resistance surveillance.

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