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May 13, 2026JAC-Antimicrobial Resistance0 citationsOpen Access

Improvements in antimicrobial reporting in Australian and New Zealand laboratories after publication of national guidelines: a follow-up survey from the Royal College of Pathologists of Australasia Quality Assurance Programs

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JEJuliet ElvyKRKatherine RyanMOMelanie Otormin

Key Points

  • The study aims to evaluate improvements in antimicrobial reporting practices following the publication of national guidelines.
  • Conducted a repeat laboratory survey in 2023 and compared results to the 2017 survey.
  • Analyzed antimicrobial reporting practices from two routine external quality assurance samples.
  • Focused on selective reporting and inappropriate antibiotic reporting for E. coli and Klebsiella pneumoniae.
  • In 2023, 47% of laboratories over-reported antibiotics for fully susceptible E. coli in blood cultures, down from 65% in 2017 (P=0.03).
  • For E. coli in urine cultures, 26% of laboratories reported amoxicillin-clavulanate compared to 49% in 2017 (P=0.006).
  • A reduction in inappropriate antibiotic reporting for Klebsiella pneumoniae in blood cultures, from 12% in 2017 to 2% in 2023 (P=0.02).

Abstract

Abstract Objectives In 2017, a Royal College of Pathologists of Australasia Quality Assurance Programs (RCPAQAP) laboratory survey demonstrated suboptimal antimicrobial susceptibility reporting practices. In response, the RCPA published Selective Reporting of Antimicrobials Guidelines to support selective and cascade reporting of antimicrobials. We sought to revisit laboratory antimicrobial reporting practices since these guidelines were published. Materials and methods We carried out a repeat of the laboratory survey in 2023 and compared results to the previous 2017 report. We also studied antimicrobial reporting practices from two routine external quality assurance (EQA) samples dispatched by the RCPAQAP. Results In 2023, compared with 2017, there was an overall improvement in selective reporting and a reduction in reporting of antibiotics inappropriate for bacteraemia. For a fully susceptible Escherichia coli in blood cultures, fewer laboratories over-reported antibiotics 29/62 (47%) and 55/84 (65%), respectively, P = 0.03 or reported ciprofloxacin 13/55 (24%) and 41/73 (56%), respectively, P = 0.03. Similarly, for a fully susceptible E. coli in urine, fewer laboratories reported amoxicillin-clavulanate 15/57 (26%) and 44/90 (49%), respectively, P = 0.006 and ciprofloxacin 6/51 (12%) and 12/57 (21%), respectively, P = 0.21. For a wild-type Klebsiella pneumoniae in blood culture, fewer laboratories reported inappropriate antibiotics for bacteraemia 11/94 (12%) and 1/62 (2%), P = 0.02. Conclusions We demonstrate an improvement in selective antimicrobial reporting following the publication of national antimicrobial reporting guidelines for laboratories, but opportunities for further improvement and standardization remain. This work is encouraging and highlights how microbiology laboratories can be supported to contribute to antimicrobial stewardship efforts.

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Cite This Study

Elvy et al. (2026) studied this question.

synapsesocial.com/papers/6a04153d79e20c90b4445145https://doi.org/10.1093/jacamr/dlag069
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