Monday September 16th 2019

Protecting nursing home residents with proper antibiotic use

New recommendations from the Centers for Disease Control and Prevention advise all nursing homes to improve antibiotic prescribing practices and reduce their inappropriate use to protect residents from the consequences of antibiotic-resistant infections, such as C. difficile.

To guide these improvements, the CDC released a new resource: Core Elements of Antibiotic Stewardship for Nursing Homes. The document expands upon the CDC’s recommendation last year that all acute care hospitals implement an antibiotic stewardship program designed to optimize treatment of infections while reducing adverse events associated with antibiotic use.

About 4.1 million Americans are admitted to or reside in nursing homes each year, and antibiotics are the most frequently prescribed — and often given incorrectly —medications in nursing homes.

“Superbugs that are hard to treat pose a health risk to all Americans, particularly the elderly whose bodies don’t fight infection as well,” said CDC Director Tom Frieden. “One way to keep older Americans safe from these superbugs is to make sure antibiotics are used appropriately all the time and everywhere, particularly in nursing homes.”

The core elements provide practical ways for nursing homes to initiate or expand antibiotic stewardship activities. The guide provides examples of how antibiotic use can be monitored and improved by nursing home leadership and staff. The companion checklist can be used to assess policies and practices already in place and to review progress in expanding stewardship activities on a regular basis.

However, depending on resources, some facilities may need more time to implement all these important protections. Ultimately, nursing home antibiotic stewardship activities should, at a minimum, include the following:

  • 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 experts 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, such as C. difficile infections, from antibiotics in the facility.
  • Reporting: Share information with health care providers and staff about how antibiotics are used in the facility.
  • Education: Provide resources to health care providers, nursing staff, residents and families to learn about antibiotic resistance and opportunities for improving antibiotic use.

The release of CDC’s Core Elements for Nursing Homes is one step in achieving the objectives set out in the “National Action Plan for Combating Antibiotic-resistant Bacteria.” Investments to improve antibiotic stewardship across all settings are part of the CDC’s antibiotic resistance solutions initiative for fiscal year 2016.

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