Burden of skin disease in two remote primary healthcare centres in northern and central Australia

Thomas, Lauren; Bowen, Asha C; Ly, Marleesa; Connors, Christine; Andrews, Ross M.; Tong, Steven Y. C.

doi:10.1111/imj.14222

Cited by 24 publications

(21 citation statements)

References 17 publications

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“…Of critical concern, CA-MRSA was documented in over 40% of SSTIs, either by wound culture or presumed by previous colonization. Although research around skin infections in Indigenous communities is limited, this high burden of infection aligns with the current literature; in Australia, researchers have found that 75% of residents from two remote Australian Indigenous communities visited a primary healthcare centre with a skin infection at least once in a year, and skin infections were the dominant reason for visiting a primary healthcare centres in Indigenous communities [19]. They also found MRSA rates around 50% in the north (of Australia) [20], and highlighted the high burden of skin infections in Indigenous communities in Australia.…”

Section: Discussionsupporting

confidence: 64%

Antibiotic use among twelve Canadian First Nations communities: a retrospective chart review of skin and soft tissue infections

et al. 2020

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Background: Previous publications indicated an emerging issue with community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA), particularly skin and soft tissue infections (SSTIs), in Indigenous communities in Canada. The objectives of this analysis were to explore the prevalence of SSTIs due to CA-MRSA and patterns of antimicrobial use in the community setting. Methods: A retrospective chart review was conducted as part of an environmental scan to assess antibiotic prescriptions in 12 First Nations communities across five provinces in Canada including Alberta, Saskatchewan, Manitoba, Ontario, and Québec. Charts were randomly selected from nursing stations and patients who had accessed care in the previous 12 months and were ≥ 18 years were included in the review. Data was collected from September to December, 2013 on antibiotic prescriptions, including SSTIs, clinical symptoms, diagnostic information including presence of CA-MRSA infection, and treatment. Results: A total of 372 charts were reviewed, 60 from Alberta, 70 from Saskatchewan, 120 from Manitoba, 100 from Ontario, and 22 from Québec. Among 372 patients, 224 (60.2%) patients had at least one antibiotic prescription in the previous 12 months and 569 prescriptions were written in total. The prevalence of SSTIs was estimated at 36.8% (137 cases of SSTIs in 372 charts reviewed). In 137 cases of SSTIs, 34 (24.8%) were purulent infections, and 55 (40.2%) were due to CA-MRSA. Conclusions: This study has identified a high prevalence of antibiotic use and SSTIs due to CA-MRSA in remote and isolated Indigenous communities across Canada. This population is currently hard to reach and underrepresented in standard surveillance system and randomized retrospective chart reviews can offer complimentary methodology for monitoring disease burden, treatment and prevention.

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Section: Discussionsupporting

confidence: 64%

Antibiotic use among twelve Canadian First Nations communities: a retrospective chart review of skin and soft tissue infections

et al. 2020

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“…Many clinics have treatment guideline informed formularies, ensuring a streamlined supply of antimicrobials. Widespread use of electronic medical records provides the capacity for high level understanding of prescribing and dispensing …”

Section: The Way Forwardmentioning

confidence: 99%

“…At any one time, 45% of children will have impetigo, 7 up to 80% of infants aged under 1 year will be hospitalised for a lower respiratory tract infection, 8 66% of children will present with otitis media before 5 years of age, 9 and 75% of all community members present with skin and soft tissue infections each year. 10 In adults, skin and sexually transmitted infections remain challenging, while sepsis rates resulting in hospitalisation and intensive care admission are fourfold higher in Indigenous than in non-Indigenous Australians in northern Australia. 11 Due to this burden, high frequency appropriate antimicrobial use is required: 95% of children receive at least one antibiotic prescription and 47% receive at least six antibiotic prescriptions by their first birthday.…”

Section: Heavy Burden Of Infections and Antimicrobial Usementioning

confidence: 99%

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An urgent need for antimicrobial stewardship in Indigenous rural and remote primary health care

Bowen¹,

Daveson

Anderson³

et al. 2019

Medical Journal of Australia

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“…The data demonstrated that SSTIs were the most frequent indications for antimicrobial use in all three regions. 15,37 This finding highlights the difference in morbidity profiles and patterns of antimicrobial use between remote and urban communities, as upper respiratory tract infections are typically the most common reason for an antimicrobial prescription in urban areas. 38 The appropriateness of antimicrobial use was high compared with urban GP settings around Australia.…”

Section: Discussionmentioning

confidence: 87%

Peer Review #1 of "Antimicrobial stewardship in remote primary healthcare across northern Australia (v0.1)"

Kibuule¹

2020

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The high burden of infectious disease and associated antimicrobial use likely contribute to the emergence of antimicrobial resistance (AMR) in remote Australian Aboriginal communities. We aimed to develop and apply context-specific tools to audit antimicrobial use in the remote primary healthcare setting. Methods We adapted the General Practice version of the National Antimicrobial Prescribing Survey (GP NAPS) tool to audit antimicrobial use over 2-3 weeks in fifteen remote primary healthcare clinics across the Kimberley region of Western Australia (03/2018-06/2018), Top End of the Northern Territory (08/2017-09/2017) and far north Queensland (05/2018-06/2018). At each clinic we reviewed consecutive clinic presentations until 30 presentations where antimicrobials had been used were included in the audit. Data recorded included the antimicrobials used, indications and treating health professional. We assessed the appropriateness of antimicrobial use and functionality of the tool.

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Burden of skin disease in two remote primary healthcare centres in northern and central Australia

Cited by 24 publications

References 17 publications

Antibiotic use among twelve Canadian First Nations communities: a retrospective chart review of skin and soft tissue infections

Antibiotic use among twelve Canadian First Nations communities: a retrospective chart review of skin and soft tissue infections

An urgent need for antimicrobial stewardship in Indigenous rural and remote primary health care

Peer Review #1 of "Antimicrobial stewardship in remote primary healthcare across northern Australia (v0.1)"

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