Survey published on antimicrobial usage in New Brunswick hospitals led by Horizon staff

Horizon staff have been recognized for their outstanding work on antimicrobial usage in New Brunswick hospitals.

A Point Prevalence Survey of Antimicrobial Usage in New Brunswick Hospitals was published in Spring 2022 issue of the Canadian Journal of Hospital Pharmacy.

This survey was led by a group of pharmacists within Horizon with an interest and/or background in the infectious disease speciality. The team included:

• Rachel Cormier, Pharmacy Department of Horizon’s Dr. Everett Chalmers Regional Hospital;
• Tim MacLaggan, Pharmacy Department of Horizon’s The Moncton Hospital;
• Daniel Landry, Pharmacy Department of Dr. Georges-L.-Dumont University Hospital Centre, Vitalité Health Network;
• Rachel Harris, Pharmacy Department of Horizon’s Saint John Regional Hospital (SJRH); and
• Andrew Flewelling, PhD, Research Services, at Horizon’s SJRH.

“Our team was incredibly well-rounded with varying perspectives and expertise,” said Rachel Cormier. “I could not have imagined working with a better group of people!”

Findings from this survey reveal the important steps needed to improve quality patient care using antimicrobial drugs.

The publication encompasses a point prevalence survey (PPS) of antimicrobial utilization and appropriateness that was conducted in
10 hospitals within the province of New Brunswick, using a structured protocol and web-based data collection tool (National Antimicrobial Prescribing Survey).

Inpatients taking systemic antimicrobial(s) during admission to these hospitals were included in the study. The overall prevalence of antimicrobial use was 22.7% (500/2,200) and a total of 648 antimicrobials were ordered.

The most frequently prescribed antimicrobials by class were first-generation cephalosporins, third-generation cephalosporins, and piperacillin–tazobactam. Provincially, 68.1% (441/648) of the antimicrobial orders were deemed appropriate.

The major areas to improve antimicrobial prescribing identified by this survey include decreasing the use of broad-spectrum antimicrobials, increasing guideline compliance, and ensuring documentation of antimicrobial duration by prescribers.

“(This is) important work in showing the gaps that still exist in utilization of antimicrobial drugs and the potential for antimicrobial stewardship to improve quality of patient care,” said Doug Doucette, Horizon’s Director of Pharmacy.

The survey is the first of its kind province-wide and serves as a provincial and site benchmark for antimicrobial use and appropriateness.

“Additionally, it is the first PPS to report the association between antimicrobial appropriateness and hospital size and the presence of a penicillin allergy label,” explained Rachel. “This survey indicates where impacts of interventions intended to improve antimicrobial prescribing have occurred and targets for future efforts (to improve patient safety, reduce antimicrobial resistance etc.) This study proves that this protocol can be replicated in other parts of Canada (potential widespread use).

It may also be an effective tool to evaluate future planned interventions.

“The data represents antimicrobial use during a moment of time on one day, therefore, repetition of the survey will add more data points and provide a more realistic depiction of antimicrobial use and appropriateness,” said Rachel. In terms of evaluating future interventions, repeating such survey before and after allows us to observe trends in use and evaluate if there is was a meaningful impact of such interventions.”