Optimizing antibiotics in residents of nursing homes: protocol of a randomized trialReport as inadecuate




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BMC Health Services Research

, 2:17

First Online: 03 September 2002Received: 16 July 2002Accepted: 03 September 2002DOI: 10.1186-1472-6963-2-17

Cite this article as: Loeb, M., Brazil, K., Lohfeld, L. et al. BMC Health Serv Res 2002 2: 17. doi:10.1186-1472-6963-2-17

Abstract

BackgroundAntibiotics are frequently prescribed for older adults who reside in long-term care facilities. A substantial proportion of antibiotic use in this setting is inappropriate. Antibiotics are often prescribed for asymptomatic bacteriuria, a condition for which randomized trials of antibiotic therapy indicate no benefit and in fact harm. This proposal describes a randomized trial of diagnostic and therapeutic algorithms to reduce the use of antibiotics in residents of long-term care facilities.

MethodsIn this on-going study, 22 nursing homes have been randomized to either use of algorithms 11 nursing homes or to usual practise 11 nursing homes. The algorithms describe signs and symptoms for which it would be appropriate to send urine cultures or to prescribe antibiotics. The algorithms are introduced by inservicing nursing staff and by conducting one-on-one sessions for physicians using case-scenarios. The primary outcome of the study is courses of antibiotics per 1000 resident days. Secondary outcomes include urine cultures sent and antibiotic courses for urinary indications. Focus groups and semi-structured interviews with key informants will be used to assess the process of implementation and to identify key factors for sustainability.

Electronic supplementary materialThe online version of this article doi:10.1186-1472-6963-2-17 contains supplementary material, which is available to authorized users.

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Author: Mark Loeb - Kevin Brazil - Lynne Lohfeld - Allison McGeer - Andrew Simor - Kurt Stevenson - Stephen Walter - Dick Zoutman

Source: https://link.springer.com/







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