Infection and Antimicrobial Prescribing in Australian Residential Care Facilities – Results of the 2022 Aged Care NAPS

Megan Reilly

This report presents the findings from the annual Aged Care National Antimicrobial Prescribing Survey (NAPS). It analyses resident infection and antimicrobial use data reported by Australian aged facilities that participated in the survey.

AC NAPS continues to play a pivotal role in Australian residential aged care facilities (RACFs) as part of their infection prevention and control (IPC) and antimicrobial stewardship (AMS) programs. A total of 743 RACFs participated in the 2022 survey, an increased number from 2021 (n=690).  All provider states and territories (except the Northern Territory), remote areas and provider groups (government, not-for-profit and private) were represented.

Key results on the survey day:

  • The prevalence of residents who had signs and/or symptoms of at least one suspected infection was 3.0%; the prevalence of residents prescribed at least one antimicrobial (current/active medication order) was 12.5%.
  • Suspected skin or soft tissue (45.7%), urinary tract (21.8%) and respiratory tract (20.3%) infections continued to be the most commonly reported; only 32.8% met surveillance definitions for confirmed infections.
  • Clotrimazole (21.7%) and cefalexin (19.5%) continued to be the most commonly prescribed antimicrobials; molnupiravir (5.5%), an antiviral agent provisionally approved in Australia for treatment of mild to moderate COVID-19 in January 2022, was reported for the first time in this year’s Aged Care NAPS.
  • Documentation of indication for an antimicrobial prescription remained constant compared with 2021 (78.4%).
  • The most common indication (therapeutic or prophylactic) for prescribing antimicrobials was ‘other skin, soft tissue or mucosal infection’ (22.1%) – that is, all skin, soft tissue or mucosal infections not specifically listed as an Aged Care NAPS indication.
  • Documentation of review or stop date for an antimicrobial prescription slightly improved (55.4%) compared with 2021 but still remains well below the expected best practice target of 95%.
  • For those antimicrobials still prescribed on the survey day, over one-third (37.6%) were commenced >6 months prior.
  • A microbiology specimen was collected for less than one-quarter (22.6%) of antimicrobial prescriptions where the start date was known and <6 months prior to the survey date.

The Aged Care NAPS key results again demonstrate that there are significant opportunities for improvement. The report provides recommendations for improvement. Available at