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Antibiotic use in the nursing home. Physician practice patterns.
Archives of Internal Medicine
|July 1, 1990
Summary
Antibiotic use in nursing homes often occurs without fever or cultures, primarily for presumed infections. Despite this, most residents treated with antibiotics show favorable outcomes, indicating effective empiric prescribing.
Area of Science:
- Geriatrics
- Infectious Diseases
- Pharmacology
Background:
- Nursing home residents frequently experience infections requiring antibiotic treatment.
- Understanding antibiotic prescribing patterns is crucial for optimizing care and combating resistance.
Purpose of the Study:
- To investigate antibiotic usage patterns and clinical outcomes in nursing home residents.
- To assess the appropriateness and effectiveness of empiric antibiotic therapy.
Main Methods:
- A 1-year retrospective review of antibiotic prescriptions for 720 residents in two nursing homes.
- Analysis of indications, prescribing methods (telephone orders), culture use, and treatment modifications.
Main Results:
- 41% of prescriptions were for presumed urinary tract infections, 35% for respiratory infections.
- 54% of prescriptions were by telephone order; cultures were obtained in 60% of cases.
- 81% of residents improved or were cured; fever lacked predictive value for outcomes.
Conclusions:
- Antibiotic treatment in nursing homes is frequently initiated without fever, cultures, or patient examination.
- Empiric antibiotic prescription in this setting is generally associated with positive clinical results.