Protect Nursing Home Residents by Improving Antibiotic Stewardship in Nursing HomesPosted on by
Author: Nimalie Stone, MD
Medical Epidemiologist, CDC’s Division of Healthcare Quality Promotion
Improving the use of antibiotics in healthcare is critical to protect patients and reduce the threat of antibiotic resistance. In nursing homes, antibiotics are frequently prescribed medications; as many as 70% of residents receive antibiotics over the course of a year. However, a large number (up to 75%) of antibiotics prescribed in nursing homes are given incorrectly (e.g., the wrong drug, dose, duration, or given for the wrong reason). This antibiotic misuse can harm residents by putting them at unnecessary risk for allergic reactions, drug-drug interactions, highly resistant infections and Clostridium difficile.
CDC recommends all nursing homes implement core elements to improve antibiotic use. To support nursing home efforts to improve antibiotic use, CDC published the Core Elements of Antibiotic Stewardship for Nursing Homes. This guide outlines seven basic elements of improving antibiotic use:
- Leadership commitment: Demonstrate support and commitment to safe and appropriate antibiotic use.
- Accountability: Identify leaders who are responsible for promoting and overseeing antibiotic stewardship activities at the nursing home.
- Drug expertise: Establish access to experts with experience or training in improving antibiotic use.
- Action: Take at least one new action to improve the way antibiotics are used in the facility.
- Tracking: Measure how antibiotics are used and the complications (e.g., C. difficile infections) from antibiotics in the facility.
- Reporting: Share information with healthcare providers and staff about how antibiotics are used in the facility.
- Education: Provide resources to healthcare providers, nursing staff, residents and families to learn about antibiotic resistance and opportunities for improving antibiotic use.
CDC recommends that nursing homes start with one or two of the elements and expand their efforts in a step-wise approach. CDC’s Core Elements provides practical ways for nursing homes to initiate or expand antibiotic stewardship activities. The companion checklist can be used to assess policies and practices already in place and to review progress in expanding stewardship activities on a regular basis. CDC will be working closely with nursing home partners in ongoing implementation of the Core Elements.
Over time, we hope nursing homes will expand efforts and add new strategies to continue improving antibiotic use. We believe nursing homes that commit to antibiotic stewardship now can improve clinical care, decrease antibiotic resistance, and – most importantly – protect residents.