Systemic Antibiotic Use in Nursing Homes: A Quality Assessment

摘要: In this evaluation of the prevalence and quality systemic antibiotic use in nursing homes, 42 skilled facilities (SNFs) their 11 attached intermediate care (ICFs) were surveyed. A random sample 2238 patients (51%) from total 4378 beds was selected these, 7.7% (8.6% SNF 4.5% ICF) on antibiotics day survey. The most common suspected sites infection urinary tract (58.4%), lower respiratory (19.1%), skin or subcutaneous tissue (4.6%). Criteria for appropriateness initiating antibiotics, adequacy initial diagnostic workup, appropriate specific developed by authors, with input a group medical directors based Centers Disease Control Federal Drug Administration guidelines. Evidence to start an judged adequate 62.4% cases. Workups considered inadequate high proportion For example, urinalysis ordered only 23.8% urine culture 57.4% infections; chest x-ray 24.2% sputum 3.0% infections. Recommendations are made as minimum workup infections evidence justify antibiotic, recognizing limitations modalities home setting special problems resident populations.