Nursing Home Antibiotics: "Use Only When Needed”
Antibiotics are among the most prescribed medications in U.S. nursing homes, with the average resident on antibiotics nearly 10% of the time. Use of antibiotics in health care is a primary cause of antibiotic resistant infections. According to two researchers from University of North Carolina at Chapter Hill (UNC), overuse of antibiotics is partially the product of a mindset of prescribing “just in case,” in situations where antibiotics are not necessary or effective. These include over-diagnosis of “urinary infection” in residents with asymptomatic bacteriuria.
The blog post, published in McKnight’s Long Term Care News, outlines the nursing home antibiotic stewardship elements identified by the Centers for Disease Control and Prevention, including a system for tracking urine cultures, antibiotic starts and duration, and antibiotic-resistant infections. The Centers for Medicare & Medicaid Services expects nursing homes to have an antibiotic stewardship program in place by November 2017.*
The authors include a reference to two multi-site trials sponsored by UNC, which demonstrated that antibiotic use in nursing homes can be reduced, with positive resident outcomes. Training resources from the trials are available at nursinghomeinfections.unc.edu.