Josephine Richards, Jessica Ong2, Nigel Morlet, Simon Janda
Background: Antimicrobial stewardship is a prior- ity in our region . Antibiotics of last resort have an important place in ophthalmology and drug resis- tance is a concern. This audit is part of a comprehen- sive program of self evaluation and re?ection, comparison with available benchmarks and educa- tion followed by re- audit to promote desirable changes in prescribing behaviour.
Benchmarking / Standard: Participants were asked to select from 27 possible clinical scenarios in which antimicrobials might be used and submit 10 prospec- tive or retrospective cases. For each scenario, they were required to state the benchmark or standard from which their prescribing practise was derived. Options included: AAO benchmarks, AAO EyeWiki, Australian Medicines Handbook, Cochrane Review, Common sense, EMedicine, ESCRS guidelines 2013, Experience and training, Google search Kanski, Moorftelds Microguide, Research papers and pub- lished reviews, Wills Eye Manual, Other.
Results: Submissions received by 30 September will be analysed on the basis of evidence based vs expert opinion based vs ?common sense? prescrib- ing. Use of antibiotics of last resort (?uoroquino- lones) and perceptions of the risk of antimicrobial resistance in each case, will be analysed across all 27 scenarios Subgroup analysis will include pre and post-operative antimicrobial use in cataract surgery and antimicrobial prophylaxis for injections.
Recommendations: Scenarios in which antibiotics of last resort are being used unnecessarily will be highlighted (post-operative management following cataract surgery being the most important) and par- ticipants will be directed to evidence based informa- tion which will give them the conftdence to change prescribing patterns. Important evidence based resources will be highlighted.