From the Guidelines
Antibiotic stewardship in long-term care facilities should prioritize implementing structured programs to optimize antimicrobial use, minimize resistance, and reduce adverse effects, as recommended by the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America 1.
Key Components of Antibiotic Stewardship Programs
- Regular review of antibiotic prescriptions
- Development of facility-specific treatment guidelines
- Monitoring of antibiotic usage patterns
- Requiring documentation of antibiotic indications, expected duration, and regular reassessment of therapy at 48-72 hours
- Establishing antibiograms to guide empiric therapy choices
Importance of Antibiotic Stewardship in Long-Term Care Facilities
Long-term care facilities are significant reservoirs for multidrug-resistant organisms, and developing approaches to improve antibiotic use is crucial 2. Studies have shown that implementing antibiotic stewardship programs can lead to a decrease in systemic antibiotic use and fewer positive C. difficile tests 2.
Effective Strategies for Implementing Antibiotic Stewardship Programs
- Designating a physician champion and pharmacist to lead the program
- Providing regular education to staff about appropriate prescribing practices
- Implementing diagnostic stewardship to avoid unnecessary testing
- Involving nursing staff in stewardship interventions to reduce antibiotic use
- Using multifaceted educational interventions, such as diagnostic and treatment algorithms, to reduce antibiotic use for suspected urinary tract infections 2
Selecting Appropriate Antibiotics
Common antibiotics like trimethoprim-sulfamethoxazole, nitrofurantoin, or cephalexin for urinary tract infections, and amoxicillin-clavulanate or doxycycline for respiratory infections should be selected based on local resistance patterns 2.
Conclusion is not allowed, so the answer just ends here.
From the Research
Guidelines for Antibiotic Stewardship in Long-Term Care Facilities
The guidelines for antibiotic stewardship in long-term care (LTC) facilities are crucial to combat antimicrobial resistance and promote appropriate antimicrobial use 3. The key aspects of these guidelines include:
- Improving antimicrobial use through appropriate diagnosis, drug, dose, and duration of treatment 3
- Implementing multidisciplinary education and tools integrated into the workflow of nurses and prescribers to facilitate review of antibiotic use 4
- Involving infectious disease consultants in the stewardship program 4
- Focusing on infection control measures and antibiotic stewardship to reduce antibiotic resistance 5
Barriers to Antibiotic Stewardship in LTC Facilities
The barriers to antibiotic stewardship in LTC facilities include:
- Limited access to timely diagnostic testing 4
- Prescribers who are often off-site 4
- Variability in antibiotic use across facilities, with a 5-fold variation from the highest-use quintile to the lowest-use quintile 6
- Potential for excessive use of certain antibiotic classes, such as fluoroquinolones and cephalosporins 7
Effective Interventions for Antibiotic Stewardship in LTC Facilities
Effective interventions for antibiotic stewardship in LTC facilities include:
- Implementing antimicrobial stewardship programs that are comprehensive and interdisciplinary 3
- Using tools and resources to support antimicrobial stewardship, such as guidelines and protocols 4
- Providing education and training to healthcare providers on antimicrobial stewardship 4
- Monitoring and evaluating antibiotic use and resistance in LTC facilities 5