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Related Experiment Video

Updated: May 1, 2026

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

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Successfully reducing antibiotic prescribing in nursing homes.

Sheryl Zimmerman1, Philip D Sloane, Rosanna Bertrand

  • 1Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.

Journal of the American Geriatrics Society
|April 5, 2014
PubMed
Summary

A quality improvement (QI) program successfully reduced antibiotic prescribing in nursing homes. This intervention involved providers, staff, residents, and families, leading to fewer prescriptions and potentially better antibiotic stewardship.

Keywords:
antibiotic prescribingnursing homesquality improvement

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Last Updated: May 1, 2026

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
11:17

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

Published on: August 30, 2018

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Area of Science:

  • Geriatric Medicine
  • Infectious Diseases
  • Public Health

Background:

  • Antibiotic resistance is a growing global health concern.
  • Nursing home residents are at high risk for infections and often receive antibiotics.
  • Reducing unnecessary antibiotic use in nursing homes is crucial for stewardship.

Purpose of the Study:

  • To evaluate the effectiveness of a quality improvement (QI) program in reducing antibiotic prescribing in nursing homes.
  • To assess the impact of a multi-faceted QI program involving healthcare providers, staff, residents, and families.

Main Methods:

  • A 9-month quasi-experimental trial comparing 6 intervention and 6 comparison nursing homes in North Carolina.
  • Intervention included provider/nurse training on prescribing guidelines and resident/family education on antibiotic use.
  • Monthly feedback on prescribing patterns was provided to intervention sites.

Main Results:

  • The QI program significantly reduced antibiotic prescriptions compared to control sites (adjusted incidence rate ratio = 0.86).
  • An estimated 1.8 antibiotic prescriptions per 1,000 resident-days were avoided in intervention facilities.
  • The reduction was observed for urinary tract, skin and soft tissue, and respiratory infections.

Conclusions:

  • A comprehensive QI program can effectively decrease antibiotic prescribing in nursing homes.
  • Provider commitment, targeted education, and focus on non-indicated antibiotic use were key factors.
  • The findings suggest that similar reductions are achievable on a larger scale with sustained commitment and education.