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Antibiotics
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Rationalizing Antibiotic Use in Long-Term Care Facilities
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Rationalizing Antibiotic Use in Long-Term Care Facilities

A special issue of Antibiotics (ISSN 2079-6382). This special issue belongs to the section "Antibiotics Use and Antimicrobial Stewardship".

Deadline for manuscript submissions: closed (31 December 2023) | Viewed by 2529

Special Issue Editor

Dr. Carl Llor

E-Mail Website
Guest Editor
Research Unit for General Practice, Univeristy of South Denmark, Odense, Denmark
Interests: rational use of antibiotics; respiratory tract infections; urinary tract infections; point-of-care tests; primary health care
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The excessive and inappropriate use of antibiotics is the main cause of antimicrobial resistance, which is particularly problematic in frail, older people who are susceptible to frequent and severe infections. Antimicrobial stewardship interventions are seldom carried out in long-term care facilities. In addition, a lack of infection prevention and control leads to antimicrobial over-prescription in this setting, perpetuating antimicrobial inappropriateness. Health-care-associated infections, mainly respiratory and urinary tract infections, some of which are caused by resistant bacteria, are common but could be reduced through antibiotic stewardship and improved hygiene.

Long-term care facilities usually lack health and care resources, which has a direct impact on the health of residents. Therefore, these nursing homes constitute the best target population for intervention initiatives aimed at reducing inappropriate antibiotic use. In this Special Issue, we are planning to compile original research articles, short communications, reviews, case reports, and perspectives with a focus on reducing antibiotic inappropriateness in health-care-associated infections by implementing interventions targeting health care professionals in long-term care facilities.

Dr. Carl Llor
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Antibiotics is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Published Papers (2 papers)

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Research

12 pages, 1108 KiB  
Article
Antimicrobial Agent Use for Urinary Tract Infection in Long-Term Care Facilities in Spain: Results from a Retrospective Analytical Cohort Analysis
by Priscila Matovelle, Bárbara Olivan-Blázquez, Rosa Magallón-Botaya, Ana García-Sangenís, Ramon Monfà, Rosa Morros, Alicia Navarro Sanmartín, Jesús Mateos-Nozal, Carmen Sáez Bejar, Consuelo Rodríguez Jiménez, Elena López Pérez and Carl Llor
Antibiotics 2024, 13(2), 152; https://doi.org/10.3390/antibiotics13020152 - 03 Feb 2024
Viewed by 900
Abstract
Urinary tract infections (UTIs) are highly prevalent in long-term care facilities, constituting the most common infection in this setting. Our research focuses on analyzing clinical characteristics and antimicrobial prescriptions for UTIs in residents across nursing homes (NH) in Spain. This is a retrospective [...] Read more.
Urinary tract infections (UTIs) are highly prevalent in long-term care facilities, constituting the most common infection in this setting. Our research focuses on analyzing clinical characteristics and antimicrobial prescriptions for UTIs in residents across nursing homes (NH) in Spain. This is a retrospective analytical cohort analysis using a multifaceted approach based on the normalization process theory to improve healthcare quality provided by nursing staff in 34 NHs in Spain. In this study, we present the results of the first audit including 719 UTI cases collected between February and April 2023, with an average age of 85.5 years and 74.5% being women. Cystitis and pyelonephritis presented distinct symptom patterns. Notably, 6% of asymptomatic bacteriuria cases were treated. The prevalence of dipstick usage was 83%, and that of urine culture was only 16%, raising concerns about overreliance, including in the 46 asymptomatic cases, leading to potential overdiagnosis and antibiotic overtreatment. Improved diagnostic criteria and personalized strategies are crucial for UTI management in NHs, emphasizing the need for personalized guidelines on the management of UTIs to mitigate indiscriminate antibiotic use in asymptomatic cases. Full article
(This article belongs to the Special Issue Rationalizing Antibiotic Use in Long-Term Care Facilities)
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16 pages, 1530 KiB  
Article
A Multifaceted Intervention and Its Effects on Antibiotic Usage in Norwegian Nursing Homes
by Nicolay Jonassen Harbin, Jon Birger Haug, Morten Lindbæk, Per Espen Akselsen and Maria Romøren
Antibiotics 2023, 12(9), 1372; https://doi.org/10.3390/antibiotics12091372 - 27 Aug 2023
Cited by 1 | Viewed by 1272
Abstract
We explored the impact of an antibiotic quality improvement intervention across 33 nursing homes (NHs) in one Norwegian county, compared against four control counties. This 12-month multifaceted intervention consisted of three physical conferences, including educational sessions, workshops, antibiotic feedback reports, and academic detailing [...] Read more.
We explored the impact of an antibiotic quality improvement intervention across 33 nursing homes (NHs) in one Norwegian county, compared against four control counties. This 12-month multifaceted intervention consisted of three physical conferences, including educational sessions, workshops, antibiotic feedback reports, and academic detailing sessions. We provided clinical guiding checklists to participating NHs. Pharmacy sales data served as a measure of systemic antibiotic use. The primary outcome was a change in antibiotic use in DDD/100 BD from the baseline through the intervention, assessed using linear mixed models to identify changes in antibiotic use. Total antibiotic use decreased by 15.8%, from 8.68 to 7.31 DDD/100BD (model-based estimated change (MBEC): −1.37, 95% CI: −2.35 to −0.41) in the intervention group, albeit not a significantly greater reduction than in the control counties (model-based estimated difference in change (MBEDC): −0.75, 95% CI: −1.91 to 0.41). Oral antibiotic usage for urinary tract infections (UTI-AB) decreased 32.8%, from 4.08 to 2.74 DDD/100BD (MBEC: −1.34, 95% CI: −1.85 to −0.84), a significantly greater reduction than in the control counties (MBEDC: −0.9, 95% CI: −1.28 to −0.31). The multifaceted intervention may reduce UTI-AB use in NHs, whereas adjustments in the implementation strategy may be needed to reduce total antibiotic use. Full article
(This article belongs to the Special Issue Rationalizing Antibiotic Use in Long-Term Care Facilities)
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