Development of minimum criteria for the initiation of antibiotics in residents of long-term-care facilities: results of a consensus conference.
Establishing a clinical diagnosis of infection in residents of long-term-care facilities (LTCFs) is difficult. As a result, deciding when to initiate antibiotics can be particularly challenging. This article describes the establishment of minimum criteria for the initiation of antibiotics in residents of LTCFs. Experts in this area were invited to participate in a consensus conference. Using a modified delphi approach, a questionnaire and selected relevant articles were sent to participants who were asked to rank individual signs and symptoms with respect to their relative importance. Using the results of the weighting by participants, a modification of the nominal group process was used to achieve consensus. Criteria for initiating antibiotics for skin and soft-tissue infections, respiratory infections, urinary infections, and fever where the focus of infection is unknown were developed.
Division of Infectious Diseases and Medical Microbiology, McMaster University and Hamilton Civic Hospitals, Ontario, Canada.
M
M
Loeb
D W
DW
Bentley
S
S
Bradley
K
K
Crossley
R
R
Garibaldi
N
N
Gantz
A
A
McGeer
R R
RR
Muder
J
J
Mylotte
L E
LE
Nicolle
B
B
Nurse
S
S
Paton
A E
AE
Simor
P
P
Smith
L
L
Strausbaugh
D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002487:Centers for Disease Control and Prevention, U.S.; D003141:Communicable Diseases / Q000188:drug therapy*; D004352:Drug Resistance, Microbial; D004363:Drug Utilization / Q000592:standards*; D005334:Fever / Q000188:drug therapy; D006763:Hospitals, Chronic Disease / Q000592:standards; D006787:Hospitals, Veterans / Q000592:standards; D006801:Humans; D009735:Nursing Homes / Q000592:standards; D017410:Practice Guidelines as Topic; D012112:Residential Facilities / Q000592:standards*; D012141:Respiratory Tract Infections / Q000188:drug therapy; D012874:Skin Diseases, Infectious / Q000188:drug therapy; D014481:United States; D014552:Urinary Tract Infections / Q000188:drug therapy
D000900:Anti-Bacterial Agents