Antibiotics for nursing home residents. When are they appropriate?

Antibiotics are used often in nursing homes in response to high rates of infection. Physicians and nursing home administrators and staff need to work in concert to avoid inappropriate prescription of antibiotics in this setting. Physicians need to know how infection presents in frail, institutionalized elderly patients; strive to prevent infection; and prescribe antibiotics only in situations in which clear benefit has been demonstrated. Nursing home administrators and staff must institute comprehensive infection control programs, adopt specific guidelines for antibiotic use, and keep physicians informed about the number and types of infections and antibiotic susceptibility patterns.