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Published on: August 30, 2018
Strategies and challenges of antimicrobial stewardship in long-term care facilities
Abstract:
As people are living longer the demand for long-term care facilities (LTCFs) continues to rise. For many reasons, antimicrobials are used intensively in LTCFs, with up to a half of this use considered inappropriate or unnecessary. Over-use of antimicrobials can have direct adverse consequences for LTCF residents and promotes the development and spread of resistant bacteria. It is therefore critical that LTCFs are able to engage in antimicrobial stewardship programmes, which have the potential to minimize the antibiotic selective pressure, while improving the quality of care received by LTCF residents. To date, no antimicrobial stewardship guidelines specific to LTCF settings have been published. Here we outline the scale of antimicrobial use in LTCFs and the underlying drivers for antibiotic over-use. We further describe the particular challenges of antimicrobial stewardship in LTCFs, and review the interventional studies that have aimed to improve antibiotic use in these settings. Practical recommendations are then drawn from this research to help guide the development and implementation of antimicrobial stewardship programmes.
Insights
Antimicrobial use is high and often inappropriate in long-term care facilities (LTCFs). Implementing antimicrobial stewardship programmes is crucial to reduce resistance and improve resident care.
Area of Science:
- Gerontology
- Infectious Diseases
- Public Health
Background:
- Rising demand for long-term care facilities (LTCFs) due to aging populations.
- Intensive and often inappropriate antimicrobial use in LTCFs, with up to 50% considered unnecessary.
- Adverse consequences of antimicrobial overuse include direct harm to residents and promotion of antibiotic resistance.
Purpose of the Study:
- To outline the scale and drivers of antimicrobial use in LTCFs.
- To describe the unique challenges of antimicrobial stewardship in LTCF settings.
- To review interventions aimed at improving antibiotic use in LTCFs and provide practical recommendations.
Main Methods:
- Review of antimicrobial use patterns in LTCFs.
- Analysis of factors contributing to antibiotic overuse.
- Synthesis of findings from interventional studies on antimicrobial stewardship.
- Development of practical recommendations for LTCF antimicrobial stewardship programs.
Main Results:
- Significant overuse of antimicrobials identified in LTCFs.
- Key drivers for overuse include [specific drivers to be detailed in full study].
- Interventional studies show potential for improving antibiotic use and stewardship.
Conclusions:
- Antimicrobial stewardship programmes are essential for LTCFs to minimize antibiotic pressure.
- Effective stewardship can improve the quality of care for LTCF residents.
- Development and implementation of specific LTCF guidelines are needed.
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