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Addressing Antibiotic Use in Nursing Homes – It Starts with a Conversation

Categories: Antibiotic use, Long Term Care (LTC)

Nimalie Stone, MD

Nimalie Stone, MD

Author – Nimalie Stone MD,
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention.

As you have read in the posts from our academic and clinical partners, much work needs to be done to impact the systems and behaviors driving antibiotic use in the nursing home setting.

We believe many of the principles of antibiotic stewardship we apply in hospitals would also hold true in other healthcare settings. However, we do not have the same levels of clinical experience and research evidence to implement this activity in our nation’s nursing homes. As an important first step in developing a strategy to promote improved antibiotic use in these healthcare facilities, CDC has reached out to key partners across the nursing home industry to get their input and advice. In fact, today CDC is having face-to-face conversations with these industry stakeholders to discuss and outline next steps towards improved antibiotic use in nursing homes.

We know that antibiotic stewardship can improve the outcomes for residents who need antibiotics (and prevent the unintended consequences of antibiotic use such as side effects, development of antibiotic-resistant bacteria, and secondary complications such as Clostridium difficile infections). That said, what we need right now is a roadmap for how to develop stewardship programs within this resource-limited environment. By working with partners who represent the voices of nursing home residents, owner-operators, doctors, nurses, pharmacists, and consumers, we will lay the foundation required to launch successful antibiotic stewardship programs in these facilities. Learning from their experiences and incorporating their ideas will ensure that our strategy for promoting antibiotic stewardship in nursing homes will be meaningful and feasible for providers, and have the support of critical partners across the industry.

What steps are currently being taken to improve antibiotic use in your nursing home or long-term care facility? What additional resources would prove helpful to you in your efforts to prevent antibiotic resistance?

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Comments listed below are posted by individuals not associated with CDC, unless otherwise stated. These comments do not represent the official views of CDC, and CDC does not guarantee that any information posted by individuals on this blog is correct, and disclaims any liability for any loss or damage resulting from reliance on any such information. Read more about our comment policy ».

  1. November 16, 2012 at 1:44 pm ET  -   Jamie

    We have asked our nurses to start identifying 3 symptoms r/t suspected UTI, as opposed to “dipping” everyone; after a fall, seeing “increased confusion” in a dementia resident, cloudy urine, etc. Too often we find we are trying to treat a bug that we will never get rid of, and the resident is asymptomatic in the first place. We have removed chem9/10 strips from the building. We have politely asked MD’s to wait for culture results to prescribe antibiotics. Some agree and some do not, but at least we have started the discussion. We start pushing fluids as soon as possible if we do suspect UTI. Recently we have evaluated some admission referrals that have “colonized” MRSA of nares, yet they are being treated for it with no active symptoms, we have asked that these be d/c’d prior to admission.

    As far as resources that would be helpful, why not ask the pharmaceutical companies to present “good stewardship” to our Dr.’s. We always seem to know what the latest and greatest medications are, but we never see the pharmaceutical companies preaching how to use less of them.

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