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Abstract

Residents in long-term care are at high risk of infections because of their old age and many related health problems that lead to frequent antibiotic prescribing. The aim of the study was to assess antibiotic use in Slovenian long-term care facilities (LTCFs). The point-prevalence study was conducted between April and June 2016. Online questionnaires were sent to all Slovenian LTCFs. Eighty (68.4%) of the 117 LTCFs contacted, caring for 13,032 residents (70.6% of all Slovenian LTCF residents), responded to the survey. On the day of the study, the mean antibiotic prevalence per LTCF was 2.4% (95% confidence interval: 1.94–2.66). Most (70.2%) of the residents taking antibiotics were female. Most residents were being treated for respiratory tract (42.7%) or urinary tract (33.3%) infections. Co-amoxiclav and fluoroquinolones were the most frequently prescribed antibiotics (41.0% and 22.3% respectively). Microbiological tests were performed for 5.2% of residents receiving antibiotics. Forty nine (19.8%) residents receiving antibiotics were colonised with multidrug-resistant bacteria (MDR). Antibiotic use in Slovenian LTCFs is not very high, but most prescribed antibiotics are broad-spectrum. Together with low use of microbiological testing and high prevalence of colonisation with MDR bacteria the situation is worrisome and warrants the introduction of antimicrobial stewardship interventions.

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/content/10.2807/1560-7917.ES.2018.23.46.1800100
2018-11-15
2024-11-12
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2018.23.46.1800100
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References

  1. Eurostat. Eurostat Statistics Explained. Population age structure by major age groups, 2005 and 2015 (% of total population). Luxembourg: Eurostat. Available from: http://ec.europa.eu/eurostat/statistics-explained/index.php/File:Population_age_structure_by_major_age_groups,_2005_and_2015_(%25_of_the_total_population)_YB16.png
  2. Organisation for Economic Co-operation and Development (OECD). Long-term care beds in institutions and hospitals. In: Health at a Glance 2011. OECD Indicators. Paris: OECD; 2011. Available from: https://www.oecd.org/els/health-systems/49105858.pdf
  3. van Buul LW, van der Steen JT, Veenhuizen RB, Achterberg WP, Schellevis FG, Essink RT, et al. Antibiotic use and resistance in long term care facilities. J Am Med Dir Assoc. 2012;13(6):568.e1-13.  https://doi.org/10.1016/j.jamda.2012.04.004  PMID: 22575772 
  4. Rosello A, Hayward AC, Hopkins S, Horner C, Ironmonger D, Hawkey PM, et al. Impact of long-term care facility residence on the antibiotic resistance of urinary tract Escherichia coli and Klebsiella. J Antimicrob Chemother. 2017;72(4):1184-92. PMID: 28077671 
  5. Crnich CJ, Jump R, Trautner B, Sloane PD, Mody L. Optimizing Antibiotic Stewardship in Nursing Homes: A Narrative Review and Recommendations for Improvement. Drugs Aging. 2015;32(9):699-716.  https://doi.org/10.1007/s40266-015-0292-7  PMID: 26316294 
  6. Roukens M, Verhoef L, Stobberingh E, Natsch S. Surveillance of antimicrobial use in Dutch long-term care facilities. J Antimicrob Chemother. 2017;72(5):1516-20. PMID: 28100443 
  7. Moro ML, Ricchizzi E, Morsillo F, Marchi M, Puro V, Zotti CM, et al. Infections and antimicrobial resistance in long term care facilities: a national prevalence study. Ann Ig. 2013;25(2):109-18. PMID: 23471448 
  8. Fleet E, Gopal Rao G, Patel B, Cookson B, Charlett A, Bowman C, et al. Impact of implementation of a novel antimicrobial stewardship tool on antibiotic use in nursing homes: a prospective cluster randomized control pilot study. J Antimicrob Chemother. 2014;69(8):2265-73.  https://doi.org/10.1093/jac/dku115  PMID: 24777901 
  9. Ruscher C, Kraus-Haas M, Nassauer A, Mielke M. [Healthcare-associated infections and antimicrobial use in long term care facilities (HALT-2): German results of the second European prevalence survey]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2015;58(4-5):436-51.  https://doi.org/10.1007/s00103-015-2126-5  PMID: 25739563 
  10. Marquet A, Thibaut S, LePabic E, Huon JF, Ballereau F. Three years of antibiotic consumption evaluation in French nursing homes. Med Mal Infect. 2015;45(8):313-7.  https://doi.org/10.1016/j.medmal.2015.05.006  PMID: 26112930 
  11. European Centre for Disease Prevention and Control (ECDC). Point prevalence survey of healthcare-associated infections and antimicrobial use in European long-term care facilities. May-September 2010. Stockholm: ECDC; 6 May 2014. Available from: https://ecdc.europa.eu/en/publications-data/point-prevalence-survey-healthcare-associated-infections-and-antimicrobial-use-1
  12. European Centre for Disease Prevention and Control (ECDC). Point prevalence survey of healthcare-associated infections and antimicrobial use in European long-term care facilities. April-May 2013. Stockholm: ECDC; 2014. Available from: https://ecdc.europa.eu/sites/portal/files/media/en/publications/Publications/healthcare-associated-infections-point-prevalence-survey-long-term-care-facilities-2013.pdf
  13. The Association of Social Institutions in Slovenia. Skupnost socialnih zavodov Slovenije. Splošno o domovih in posebnih zavodih. [General information about the long-term care facilities and specialised institutions]. Ljubljana: The Association of Social Institutions in Slovenia. [Accessed 28 Feb 2018]. Slovenian. Available from: http://www.ssz-slo.si/splosno-o-domovih-in-posebnih-zavodih/
  14. The Association of Social Institutions in Slovenia. Poudarki iz analiz področja institucionalnega varstva starejših in posebnih skupin odraslih 2016. [The highlights of the analyses in the field of institutionalised care of elderly and special groups of adults]. Ljubljana: The Association of Social Institutions in Slovenia. [Accessed 28 Feb 2018]. Slovenian. Available from: http://www.ssz-slo.si/wp-content/uploads/Poudarki-iz-komulativnega-stati%C4%8Dnega-poro%C4%8Dila-za-leto-2016.pdf
  15. Latour K, Catry B, Broex E, Vankerckhoven V, Muller A, Stroobants R, et al. Indications for antimicrobial prescribing in European nursing homes: results from a point prevalence survey. Pharmacoepidemiol Drug Saf. 2012;21(9):937-44.  https://doi.org/10.1002/pds.3196  PMID: 22271462 
  16. McClean P, Hughes C, Tunney M, Goossens H, Jans B, Jans B, et al. Antimicrobial prescribing in European nursing homes. J Antimicrob Chemother. 2011;66(7):1609-16.  https://doi.org/10.1093/jac/dkr183  PMID: 21596722 
  17. Blix HS, Bergman J, Schjøtt J. How are antibacterials used in nursing homes? Results from a point-prevalence prescription study in 44 Norwegian nursing homes. Pharmacoepidemiol Drug Saf. 2010;19(10):1025-30.  https://doi.org/10.1002/pds.1980  PMID: 20712026 
  18. Marchi M, Grilli E, Mongardi M, Bedosti C, Nobilio L, Moro ML. Prevalence of infections in long-term care facilities: how to read it? Infection. 2012;40(5):493-500.  https://doi.org/10.1007/s15010-012-0266-1  PMID: 22576022 
  19. Rummukainen ML, Mäkelä M, Noro A, Finne-Soveri H, Lyytikäinen O. Assessing prevalence of antimicrobial use and infections using the minimal data set in Finnish long-term care facilities. Am J Infect Control. 2013;41(4):e35-7.  https://doi.org/10.1016/j.ajic.2012.09.007  PMID: 23332375 
  20. Wu LD, Walker SAN, Elligsen M, Palmay L, Simor A, Daneman N. Antibiotic Use and Need for Antimicrobial Stewardship in Long-Term Care. Can J Hosp Pharm. 2015;68(6):445-9.  https://doi.org/10.4212/cjhp.v68i6.1500  PMID: 26715780 
  21. Pettersson E, Vernby A, Mölstad S, Lundborg CS. Infections and antibiotic prescribing in Swedish nursing homes: a cross-sectional study. Scand J Infect Dis. 2008;40(5):393-8.  https://doi.org/10.1080/00365540701745279  PMID: 18418800 
  22. Stahlmann R, Lode HM. Risks associated with the therapeutic use of fluoroquinolones. Expert Opin Drug Saf. 2013;12(4):497-505.  https://doi.org/10.1517/14740338.2013.796362  PMID: 23651367 
  23. Salvo F, De Sarro A, Caputi AP, Polimeni G. Amoxicillin and amoxicillin plus clavulanate: a safety review. Expert Opin Drug Saf. 2009;8(1):111-8.  https://doi.org/10.1517/14740330802527984  PMID: 19236222 
  24. Stone ND, Lewis DR, Johnson TM 2nd, Hartney T, Chandler D, Byrd-Sellers J, et al. Methicillin-resistant Staphylococcus aureus (MRSA) nasal carriage in residents of Veterans Affairs long-term care facilities: role of antimicrobial exposure and MRSA acquisition. Infect Control Hosp Epidemiol. 2012;33(6):551-7.  https://doi.org/10.1086/665711  PMID: 22561709 
  25. Nicolle LE, Bentley DW, Garibaldi R, Neuhaus EG, Smith PWSHEA Long-Term-Care Committee. Antimicrobial use in long-term-care facilities. Infect Control Hosp Epidemiol. 2000;21(8):537-45.  https://doi.org/10.1086/501798  PMID: 10968724 
  26. Montgomery P, Semenchuck M, Nicolle LE. Antimicrobial use in nursing homes in Manitoba. J Geriatr Drug Ther. 1995;9(3):55-74.  https://doi.org/10.1300/J089v09n03_05 
  27. Hogardt M, Proba P, Mischler D, Cuny C, Kempf VA, Heudorf U. Current prevalence of multidrug-resistant organisms in long-term care facilities in the Rhine-Main district, Germany, 2013. Euro Surveill. 2015;20(26):21171.  https://doi.org/10.2807/1560-7917.ES2015.20.26.21171  PMID: 26159310 
  28. Flokas ME, Alevizakos M, Shehadeh F, Andreatos N, Mylonakis E. Extended-spectrum β-lactamase-producing Enterobacteriaceae colonisation in long-term care facilities: a systematic review and meta-analysis. Int J Antimicrob Agents. 2017;50(5):649-56.  https://doi.org/10.1016/j.ijantimicag.2017.08.003  PMID: 28782707 
Antimicrobial prescribing in long-term care facilities: a nationwide point-prevalence study, Slovenia, 2016
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Dora+Stepan&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Stepan Dora</a>, <a href="/search?value1=Lea+U%C5%A1aj&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Ušaj Lea</a>, <a href="/search?value1=Marija++Petek+%C5%A0ter&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Petek Šter Marija </a>, <a href="/search?value1=Marjetka+Smolinger+Galun&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Smolinger Galun Marjetka</a>, <a href="/search?value1=Hermina+Smole&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Smole Hermina</a>, <a href="/search?value1=Bojana+Beovi%C4%87&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Beović Bojana</a></span>. Antimicrobial prescribing in long-term care facilities: a nationwide point-prevalence study, Slovenia, 2016. <a href="/content/ecdc">Euro Surveill.</a> 2018;23(46):pii=1800100. <a href="https://doi.org/10.2807/1560-7917.ES.2018.23.46.1800100" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2018.23.46.1800100</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 05 Mar 2018;&nbsp;&nbsp; <span class="generated">Accepted</span>: 14 Jul 2018 </span> </p>
/content/10.2807/1560-7917.ES.2018.23.46.1800100
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    • Supplement. Patient with antibiotics prescribed per indication

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