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Measuring Antibiotic Appropriateness for Urinary Tract Infections in Nursing Home Residents

Published online by Cambridge University Press:  31 May 2017

Taniece Eure*
Affiliation:
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
Lisa L. LaPlace
Affiliation:
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
Richard Melchreit
Affiliation:
Connecticut Department of Public Health, Hartford, Connecticut
Meghan Maloney
Affiliation:
Connecticut Department of Public Health, Hartford, Connecticut
Ruth Lynfield
Affiliation:
Minnesota Department of Health, St Paul, Minnesota
Tory Whitten
Affiliation:
Minnesota Department of Health, St Paul, Minnesota
Linn Warnke
Affiliation:
Minnesota Department of Health, St Paul, Minnesota
Ghinwa Dumyati
Affiliation:
University of Rochester Medical Center and Rochester-NY EIP, Rochester, New York
Gail Quinlan
Affiliation:
University of Rochester Medical Center and Rochester-NY EIP, Rochester, New York
Cathleen Concannon
Affiliation:
University of Rochester Medical Center and Rochester-NY EIP, Rochester, New York
Deborah Thompson
Affiliation:
New Mexico Department of Health, Santa Fe, New Mexico.
Nimalie D. Stone
Affiliation:
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
Nicola D. Thompson
Affiliation:
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
*
Address correspondence to Taniece Eure, MPH, Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, 1600 Clifton Road MS A-16, Atlanta, GA 30329 ([email protected]).

Abstract

We assessed the appropriateness of initiating antibiotics in 49 nursing home (NH) residents receiving antibiotics for urinary tract infection (UTI) using 3 published algorithms. Overall, 16 residents (32%) received prophylaxis, and among the 33 receiving treatment, the percentage of appropriate use ranged from 15% to 45%. Opportunities exist for improving UTI antibiotic prescribing in NH.

Infect Control Hosp Epidemiol 2017;38:998–1001

Type
Concise Communications
Copyright
© 2017 by The Society for Healthcare Epidemiology of America. All rights reserved 

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Footnotes

PREVIOUS PRESENTATION: An abstract of this work, “Measuring Antibiotic Appropriateness for Urinary Tract Infection in Nursing Home Residents,” was presented in Atlanta, Georgia, on May 20, 2016, at the Society for Healthcare Epidemiologists of America Spring Conference.

References

REFERENCES

1. Nicolle, LE, Bentley, DW, Garibaldi, R, Neuhaus, EG, Smith, PW. Antimicrobial use in long-term-care facilities. SHEA Long-Term-Care Committee. Infect Control Hosp Epidemiol 2000;21:537545.CrossRefGoogle ScholarPubMed
2. Rotjanapan, P, Dosa, D, Thomas, KS. Potentially inappropriate treatment of urinary tract infections in two Rhode Island nursing homes. Arch Intern Med 2011;171:438443.Google Scholar
3. Giannella, M, Tedeschi, S, Bartoletti, M, Viale, P. Prevention of infections in nursing homes: antibiotic prophylaxis versus infection control and antimicrobial stewardship measures. Expert Rev Anti Infect Ther 2016;14:219230.Google Scholar
4. Phillips, CD, Adepoju, O, Stone, N, et al. Asymptomatic bacteriuria, antibiotic use, and suspected urinary tract infections in four nursing homes. BMC Geriatr 2012;12:73.CrossRefGoogle ScholarPubMed
5. Thompson, N, LaPlace, L, Epstein, L, et al. Prevalence of antimicrobial use and opportunities to improve prescribing practices in US nursing homes. J Am Med Dir Assoc Issue. 2016 Oct 14. pii S1525-8610:30365–30366.Google Scholar
6. Stone, ND, Ashraf, MS, Calder, J, et al. Surveillance definitions of infections in long-term care facilities: revisiting the McGeer criteria. Infect Control Hosp Epidemiol 2012;33:965977.CrossRefGoogle ScholarPubMed
7. Loeb, M, Bentley, DW, Bradley, S, et al. Development of minimum criteria for the initiation of antibiotics in residents of long-term-care facilities: results of a consensus conference. Infect Control Hosp Epidemiol 2001;22:120124.Google Scholar
8. Crnich, CJ, Drinka, PJ. Improving the management of urinary tract infections in nursing homes: it’s time to stop the tail from wagging the dog. Ann Long Term Care 2014:4347.Google Scholar
9. Nicolle, LE, Bradley, S, Colgan, R, et al. Infectious Diseases Society of America guidelines for the diagnosis and treatment of asymptomatic bacteriuria in adults. Clin Infect Dis 2005;40:643–554.CrossRefGoogle Scholar
10. Loeb, M, Brazil, K, Lohfeld, L, et al. Effect of a multifaceted intervention on number of antimicrobial prescriptions for suspected urinary tract infections in residents of nursing homes: cluster randomized controlled trial. BMJ 2005 Sep 24;331(7518):669.Google Scholar
11. The core elements of antibiotic stewardship for nursing homes. Centers for Disease Control and Prevention website. http://www.cdc.gov/longtermcare/index.html. Published 2015. Accessed April 20, 2017.Google Scholar