[12-year infection policy in a nursing homes].
OBJECTIVE
To evaluate the management of infections in a nursing home.


METHODS
A descriptive study of yearly reviews of 1981-1992.


METHODS
Nursing home De Bieslandhof, Delft.


METHODS
Of all the patients admitted during a year in the nursing home, the prescribed antimicrobial therapy differentiated by localisation of infection was registered. Whenever prescription of antimicrobial therapy was considered, the use of an indwelling catheter was limited and urine was collected for culturing.


RESULTS
From 1981-1984 the number of patients with an indwelling catheter decreased to 50% as did the number of patients who needed recurrent antimicrobial therapy. From 1985 on, the patients receiving a simple or repeated antimicrobial therapy courses were 20% and 7%, respectively, of the total population. Per 1000 patient days 0.9 urinary and 1.1 airway infections were treated; other infections played a minor part. Non-catheterised nursing home patients or non-catheterised patients just admitted from the hospital had more urinary E. coli infections than patients who had been catheterised. The choice of antimicrobial therapy did not change during the study period except for the replacement of sulfamethizole by pipemidic acid in 1989.


CONCLUSIONS
Nursing home doctors can collectively manage and control infections in a nursing home by using a restrictive policy on antimicrobial therapy and on the use of indwelling catheters. Infections not treated with antimicrobial agents are not included in this policy.
Cools
H J
HJ
Rijksuniversiteit, vakgroep Huisartsgeneeskunde, Instituut voor Huisarts- en Verpleeghuisgeneeskunde, Leiden.
D000368:Aged; D000369:Aged, 80 and over; D000890:Anti-Infective Agents / Q000627:therapeutic use; D004352:Drug Resistance, Microbial; D005260:Female; D006801:Humans; D017053:Infection Control; D008297:Male; D009735:Nursing Homes / Q000458:organization & administration*; D016134:Organizational Policy; D012141:Respiratory Tract Infections / Q000188:drug therapy; D014552:Urinary Tract Infections / Q000188:drug therapy
D000890:Anti-Infective Agents
Twaalf jaar infectiebeleid in een verpleeghuis.