長期療養施設における抗菌薬適正使用：エビデンスに基づく介入、実施ツール、および影響指標

While Centers for Medicare and Medicaid Services-mandated Antimicrobial Stewardship Programs are now in place across U.S. skilled nursing facilities, reported high rates of compliance may mask persistent gaps in clinical effectiveness. This review summarizes evidence-based antimicrobial stewardship interventions, their impact, and practical tools to support implementation. Resources from Centers for Disease Control and Prevention, Agency for Healthcare Research and Quality, other frameworks, and proposed metrics are highlighted to guide effective stewardship in resource-variable nursing home settings.