Infections and antibiotic prescribing in Swedish nursing homes: a cross-sectional study.
The aim of this study was to present and assess the treatment of infections in Swedish nursing homes. It included 58 nursing homes with 3002 residents. During 3 months, nurses in the nursing homes recorded all infections requiring a physician's opinion. Of the 889 infectious episodes, 84% were treated with antibiotics. Many of the antibiotics were issued after indirect contact with the physician (38%). Indications for antibiotics were in 55% of the cases urinary tract infections (UTI), in 17% skin and soft-tissue infections and in 15% respiratory tract infections (RTI). The most common antibiotics were penicillins (38%), followed by quinolones (23%) and trimethoprim (18%). For the major indication, lower UTI in women, half of the cases were not treated according to the recommendations. The main concerns were length of treatment and overprescribing of quinolones. For the second major diagnosis, pneumonia, the high use of doxycycline could be questioned. Continuing education on infections and their treatment in nursing homes is needed. Training should preferably include both physicians and nurses as a high proportion of antibiotics is issued without direct contact with the physician.
Pettersson
Eva
E
Department of Public Health Sciences, Division of International Health, IHCAR, Karolinska Institute, Stockholm, Sweden. eva.pettersson@ki.se
Vernby
Asa
A
Mölstad
Sigvard
S
Lundborg
Cecilia Stålsby
CS
D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003141:Communicable Diseases / Q000188:drug therapy*; D003430:Cross-Sectional Studies; D011307:Drug Prescriptions; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006282:Health Personnel / Q000193:education; D006302:Health Services Research; D006801:Humans; D008297:Male; D009735:Nursing Homes; D011361:Professional Competence; D012141:Respiratory Tract Infections / Q000188:drug therapy; D017192:Skin Diseases, Bacterial / Q000188:drug therapy; D018461:Soft Tissue Infections / Q000188:drug therapy; D013548:Sweden; D014552:Urinary Tract Infections / Q000188:drug therapy
D000900:Anti-Bacterial Agents