Antibiotic Use in the Nursing Home

摘要: • Antibiotic usage patterns were studied in two nonproprietary nursing homes that included 720 intermediate care and skilled home beds. Medical records of residents receiving antibiotics reviewed every fourth month for 1 year. Of 181 antibiotic prescriptions written indications other than prophylaxis, 41% presumed urinary tract infections, 35% respiratory 14% skin/soft-tissue infections. The majority (54%) made by telephone order. Cultures obtained 60% suspected infections; thirds cultures the urine. Antibiotics changed during course therapy only 12% cases. Eighty-one percent treated with improved or cured, 9.5% hospitalized died, an additional failed to improve but remained home. Fever was present 48% cases prior treatment, had no predictive value patient outcome. We conclude treatment is often initiated In absence fever, culture information, examination patient. Empiric prescription this setting generally associated favorable clinical course. (Arch Intern Med. 1990;150:1465-1468)