How does antibiotic use in Australian residential aged care compare globally?: a systematic review and meta-analysis
Dr Magdalena Raban1, Dr Peter Gates1, Dr Claudia Gasparini1, Professor Johanna Westbrook1
1Australian Institute of Health Innovation, Macquarie University, Sydney
Introduction
Inappropriate antibiotic use in residential aged care (RAC) is a concern globally. The World Health Organization recommends surveillance of antibiotic use as part of its strategy to curb antimicrobial resistance. A number of recent programs have been initiated to monitor antibiotic use in RAC; however, a global comparison of estimates from these is not available. We aimed to analyse the international literature to summarise antibiotic use in RAC by region, including for Australia.
Methods
We conducted a systematic review, meta-analysis and meta-regression of key indicators of antibiotic use in RAC. Random effects meta-analyses with subgroups by region were conducted. Meta-regression compared use in regions (providing odds ratios [OR]), while adjusting for year of data.
Results
Ninety articles reporting antibiotic use across 38 countries were included. Meta-analyses and meta-regression were conducted for point prevalence (n=123 estimates) and 12-month period prevalence (n=19 estimates) of antibiotic use. Data reported for other measures of antibiotic use (e.g. days of therapy/1000 resident days; defined daily doses/1000 resident days) precluded meta-analysis and were summarised narratively. People living in RAC in Australia had higher odds of using an antibiotic on a single day and over 12-months compared to other regions (e.g. Eastern Europe, Western Europe, Asia and the British Isles). Point estimates and odds ratios with 95% confidence intervals will be presented.
Conclusion
Antibiotic use in RAC in Australia is higher compared to some regions. There is a need for targeted antimicrobial stewardship programs in RAC to reduce unnecessary antibiotic use in this population.
Biography:
Dr Magda Raban (BPharm, MIPH, PhD) is a Senior Research Fellow and NHMRC Early Career Fellow in the Centre for Health System and Safety Research. She is the lead for the Medication Safety and Electronic Decision Support research stream within the Centre. Dr Raban’s research focuses on the use of information technology to improve the quality use of medicines and patient outcomes across a range of care settings. Her interests include the use of routinely collected data to inform quality improvement and policy. Dr Raban has experience leading multi-method evaluations, including randomised trials, of health service interventions.