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Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
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Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses

Published on: August 30, 2018

Issues in the management of resistant bacteria in long-term-care facilities

S F Bradley1

  • 1Department of Internal Medicine, Veterans' Affairs Health Systems, the University of Michigan Medical School, Ann Arbor 48105, USA.

Infection Control and Hospital Epidemiology
|June 1, 1999
PubMed

Insights

Antibiotic resistance in nursing homes is not well understood, posing risks to residents. More research is needed on gram-negative bacteria and effective, low-cost precautions for these facilities.

Area of Science:

  • Infectious Diseases
  • Geriatric Medicine
  • Public Health

Background:

  • The prevalence and risk of antibiotic-resistant bacteria in long-term-care (LTC) facilities remain largely unknown.
  • Existing research in community-based nursing homes primarily focuses on colonization rather than infection rates.
  • While methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci are recognized concerns, antibiotic resistance in gram-negative bacilli is understudied.

Purpose of the Study:

  • To highlight the unknown prevalence and risks of antibiotic resistance in nursing home residents.
  • To emphasize the need for more research on gram-negative bacilli resistance in LTC settings.
  • To advocate for the development of simple, effective, and inexpensive antibiotic resistance precautions tailored for nursing homes.

Main Methods:

  • This study is a review and synthesis of existing literature on antibiotic resistance in nursing homes.
  • It identifies gaps in current research, particularly concerning gram-negative bacilli.
  • It discusses the unique challenges and needs of chronic-care facilities in implementing infection control measures.

Main Results:

  • The exact prevalence and risk of antibiotic resistance among nursing home residents are not well established.
  • There is a significant gap in research focusing on antibiotic resistance in gram-negative bacilli within these settings.
  • Current concerns often overshadow the less-studied but critical issue of gram-negative resistance.

Conclusions:

  • Urgent need for comprehensive studies to determine the prevalence and impact of antibiotic resistance in nursing homes.
  • Development of tailored, practical, and cost-effective antibiotic resistance prevention strategies is crucial for LTC facilities.
  • Future precautions must consider the specific rehabilitative and long-term care missions of these institutions.

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