Prison antimicrobial surveillance project

Project Summary

This project aimed to assess feasibility of surveillance of antimicrobial use in South Australian (SA) prisons. The 12-month pilot sought to define and identify the data points for collection, build an online platform for data upload, categorise the prisons for suitable data comparisons, and construct meaningful reports from the data gathered to inform and support antimicrobial stewardship activities.

Improper use of antimicrobials leads to antimicrobial resistance in microbes, reducing our ability to treat infections. It is important to look at usage of antimicrobials in sectors other than hospitals such as the healthcare services in prisons. 

There are 115 prisons across Australia with an average of 65,000 individuals moving in and out of them annually¹. There is currently no uniform monitoring of antimicrobial use in prisons, and the impact that this gap has on the emergence and spread of antimicrobial resistance within these facilities and the wider community remains unclear.

Through the collaborative efforts with SA prisons and the South Australian Prison Health Services (SAPHS), a process of routine surveillance of antimicrobial usage in SA prisons was established with the following findings:

  • Unlike the hospital surveillance system, multiple data sources were identified, including the pharmacy suppliers, the tertiary hospitals, SAPHS and the prison administration.
  • Defined daily doses (DDD) and total occupied prison beds (OBDs) were used to calculate antimicrobial usage rates. The rates represent facility-wide usage rates and are a surrogate measure based on monthly antimicrobial supplies.
  • An independent NAUSP online platform was built for submission of the prison data and extraction of prison-specific reports.
  • Based on the requirements of the prison healthcare staff, relevant antimicrobial usage reports were developed that may assist them with antimicrobial stewardship activities.
  • Surveillance in this setting using a NAUSP platform is feasible and may be considered for national roll-out in the future.

Further Information

For further information on the prison project, contact the NAUSP team


  1. ABS. Corrective Service, Australia 2022.