Matt Rawlins is a Curtin University pharmacy graduate. He was the first antibiotic pharmacist at St Mary’s Hospital London, UK and returned to be the infectious diseases pharmacist at Royal Perth Hospital from 2004 to 2014 and co-founded their long-running antimicrobial stewardship program. In late 2014, he moved to Fiona Stanley Hospital as the Antimicrobial Stewardship Senior Pharmacist and continues his role as a key member of the team and well known hospital personality. He has been WA representative on the Steering Committee for the ID pharmacy COSP since its inception. He has presented throughout Australia as well as publishing several papers in the field of Antimicrobial Stewardship.
Antimicrobial prescribing is common in the elderly, especially in residential aged-care facilities (RACF), with an estimated 50-80% of residents receiving at least one course annually.
A point-prevalence survey of antimicrobial use in RACF across most regions of Australia in 2015 concluded that antimicrobial use was still occurring despite a lack of evidence for current infection, especially for skin, soft tissue, eye or oral infections, respiratory and urinary tract infections. The inappropriate prescribing of antibiotics for asymptomatic bacteriuria remained present despite an ongoing campaign from the National Prescribing Service.1 Antimicrobial use may be contributing to the higher prevalence of multi-drug resistant pathogens in this population.
Antimicrobial stewardship is evolving in the RACF sector, however many challenges must be overcome before antimicrobial prescribing is likely to improve.
1. Australian Commission on Safety and Quality in Health Care (ACSQHC). AURA 2016: first Australian report on antimicrobial use and resistance in human health. Sydney: ACSQHC, 2016.