Antibiotic stewardship important for keeping older people healthy

According to the Centers for Disease Control and Prevention (CDC), up to 70 percent of nursing home residents receive one or more courses of antibiotics a year. Any time antibiotics are used, they can cause side effects and lead to antibiotic resistance, where bacteria become resistant to the use of antibiotics. Antibiotic-resistant bacteria are harder to kill and can cause untreatable infections that spread among residents. Antibiotic resistance is one of the most urgent threats to long-term care. That’s why it’s important to improve antibiotic prescribing practice for nursing homes.
When are antibiotics appropriate?
Multiple studies have found that older people, especially those in nursing care, are often inappropriately prescribed antibiotics. Antibiotics are only needed for treating certain infections caused by bacteria. Antibiotics are also critical tools for treating common infections, such as pneumonia, and for life-threatening conditions including sepsis. Antibiotics do not work on viruses, such as those that cause colds, flu, bronchitis, or runny noses. Antibiotics also aren’t needed for some common bacterial infections, including many sinus infections and some ear infections. Although antibiotics are important, life-saving drugs, they can be harmful to the elderly population. They can kill beneficial bacteria in the body, which can lead to other illnesses such as vaginal yeast infections. Antibiotics can also cause severe side effects in older people such as diarrhea, nausea, upset stomach, dizziness, and temporary delirium. Severe side effects can lead to rehospitalization and even death.
Encouraging antibiotic stewardship
Antibiotic stewardship is a set of principles and actions designed to make sure residents receive the right dose, of the correct antibiotic, for the right duration; and only if truly necessary. Improving antibiotic use helps ensure antibiotics are effective and available when needed. The CDC recommends that skilled nursing facilities implement the following steps to improve antibiotic stewardship:
- Leadership commitment: Demonstrate support and commitment to safe and appropriate antibiotic use.
- Accountability: Identify leaders who are responsible for promoting and overseeing antibiotic stewardship activities at the nursing home.
- Drug expertise: Establish access to individuals with experience or training in improving antibiotic use.
- Action: Take at least one new action to improve the way antibiotics are used in the facility.
- Tracking: Measure how antibiotics are used and the complications from antibiotics in the facility.
- Reporting: Share information with healthcare providers and staff about how antibiotics are used in the facility.
- Education: Provide resources to healthcare providers, nursing staff, residents and families to learn about antibiotic resistance and opportunities for improving antibiotic use.
Reference:
Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases. Core Elements for Antibiotic Stewardship in Nursing Homes: What you need to know about antibiotics in a nursing home
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