Antimicrobial use in long-term-care facilities. SHEA Long-Term-Care Committee

Area of Science:

• Infectious Diseases
• Geriatrics
• Public Health

Background:

• Long-term-care facilities (LTCFs) exhibit high rates of antimicrobial use, frequently documented as inappropriate.
• The escalating crisis of antimicrobial resistance amplifies concerns regarding antimicrobial prescribing practices within LTCFs.
• Challenges in optimizing antimicrobial use include patient population characteristics, diagnostic test limitations, and a scarcity of clinical trials.

Purpose of the Study:

• To recommend evidence-based approaches for managing common infections in LTCF residents.
• To propose minimal standards for establishing and implementing antimicrobial stewardship programs in LTCFs.
• To address the unique healthcare environment and patient needs within LTCFs.

Main Methods:

• This position paper synthesizes existing literature and expert opinion.
• It reviews current antimicrobial prescribing patterns and resistance trends in LTCFs.
• Recommendations are developed considering the specific challenges of LTCF settings.

Main Results:

• Inappropriate antimicrobial use is prevalent in LTCFs, exacerbating antimicrobial resistance.
• Effective management strategies for common infections are proposed.
• Essential components for a robust antimicrobial review program are outlined.

Conclusions:

• Optimizing antimicrobial use in LTCFs is critical for combating antimicrobial resistance.
• Standardized approaches and stewardship programs are necessary to improve prescribing practices.
• Addressing the unique characteristics of LTCFs is vital for successful antimicrobial stewardship.