Antimicrobial use in long-term-care facilities

Area of Science:

• Infectious Diseases
• Geriatric Medicine
• Pharmacology

Background:

• Long-term-care facilities (LTCF) exhibit high rates of antimicrobial use, frequently documented as inappropriate.
• The escalating crisis of antimicrobial resistance (AMR) exacerbates concerns regarding antimicrobial prescribing in LTCF.
• Unique patient population characteristics, limited diagnostics, and scarce clinical trials complicate efforts to optimize antimicrobial use in LTCF.

Purpose of the Study:

• To recommend evidence-based approaches for managing common infections in LTCF.
• To propose minimal standards for implementing effective antimicrobial stewardship programs in LTCF.
• To address the specific challenges and considerations unique to antimicrobial use in the LTCF setting.

Main Methods:

• Literature review and synthesis of existing data on antimicrobial use in LTCF.
• Development of clinical management guidelines for prevalent LTCF infections.
• Formulation of recommendations for antimicrobial stewardship program components tailored to LTCF.

Main Results:

• Identified specific common infections in LTCF requiring targeted management strategies.
• Outlined essential elements for a functional antimicrobial review program in LTCF.
• Acknowledged the distinct care environment and patient needs within LTCF.

Conclusions:

• Optimizing antimicrobial use in LTCF is critical for combating AMR.
• Implementing standardized management approaches and robust antimicrobial stewardship programs can improve prescribing practices in LTCF.
• Tailored strategies are necessary to address the complexities of infection management and antimicrobial stewardship in long-term-care settings.