There is still significant overuse of antibiotics in Long Term Care. This leads to significant dangers related to drug resistant organisms and side effects related to antibiotic use. Improving our knowledge, clinical skills, and surveillance processes can help reduce antibiotic overuse as well as reduce hospitalizations and adverse drug effects.

It is estimated that 1 in 5 ER visits for an adverse drug event is related to an antibiotic. C. diff and facility transmission of antibiotic resistance are just two of many other potential adverse effects. When we prescribe a broad-spectrum antibiotic for one patient, we put everyone else in the facility at risk of acquiring a drug-resistant organism as well. Antibiotic prescribing effects the entire facility, not just one patient.

It is also now recognized that shorter courses of antibiotics are usually just as effective as longer, more traditional, courses of antibiotics. We now have randomized clinical trials showing this. Previous antibiotic recommendations were based on the 7-day week, for simplicity, and simply were not based on good evidence. At least one study has found that late career physicians are more likely to prescribe longer courses of antibiotics…. likely based on training and therapeutic inertia. By some estimates, it takes approximately 17 years for medical practitioners to change their practice pattern.

Below are some antibiotic stewardship resources for Long Term Care. At the end of the page, there is a list of hyperlinks for providers seeking an update or review on the topic of antibiotic stewardship.

DS