Antimicrobial Stewardship in Long-term Care
Studies have shown that extensive antimicrobial use in LTCFs plays a significant role in the development of drug-resistant organisms. Antimicrobials are prescribed frequently in LTCFs. At any given time, 7%-10% of residents may be receiving them. and 50%-70% of residents will receive at least one course of systemic antimicrobial therapy each year.The result of such widespread antimicrobial use is that individual residents are at risk for colonization or infection with drug-resistant organisms, including Clostridium difficile. Drug-resistant infections can be particularly detrimental to this already vulnerable patient population.
Unfortunately, determining whether a resident needs an antimicrobial is often difficult, because typical signs and symptoms of infection are frequently absent. Compounding this are the variable availability and use of laboratory and radiologic data (sometimes too little and sometimes too much) and limited consensus recommendations on the use of antimicrobials in LTCFs.Finally, the availability of clinicians to evaluate residents for possible infection is also variable; Daneman and colleagues found that less than 44% of residents had had a physician visit within 1 day of their antimicrobial prescription.
Antimicrobial Use in LTCF
Studies have shown that extensive antimicrobial use in LTCFs plays a significant role in the development of drug-resistant organisms. Antimicrobials are prescribed frequently in LTCFs. At any given time, 7%-10% of residents may be receiving them. and 50%-70% of residents will receive at least one course of systemic antimicrobial therapy each year.The result of such widespread antimicrobial use is that individual residents are at risk for colonization or infection with drug-resistant organisms, including Clostridium difficile. Drug-resistant infections can be particularly detrimental to this already vulnerable patient population.
Unfortunately, determining whether a resident needs an antimicrobial is often difficult, because typical signs and symptoms of infection are frequently absent. Compounding this are the variable availability and use of laboratory and radiologic data (sometimes too little and sometimes too much) and limited consensus recommendations on the use of antimicrobials in LTCFs.Finally, the availability of clinicians to evaluate residents for possible infection is also variable; Daneman and colleagues found that less than 44% of residents had had a physician visit within 1 day of their antimicrobial prescription.
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