title: Antibiotic prescription in nursing homes for dependent elderly people: a cross-sectional study in Franche-Comté.
abstract: OBJECTIVE
  We had for objective to determine the rate of patients treated with antibiotics and the determinants of antibiotic stewardship in nursing homes for dependent elderly people (French acronym EHPAD), of a French region (Franche-Comté).
  
  
  METHODS
  A representative sample of EHPAD, in Franche-Comté, was included in a cross-sectional study made between April and June 2012. An external auditor and the EHPAD head physician collected data on the facility and on residents receiving antibiotics on the study day. An infectious diseases specialist and an infection control practitioner analyzed each prescription, a posteriori, to assess criteria of antimicrobial stewardship including re-assessment of the prescription between 48 and 72h after initiation of antibiotic treatment.
  
  
  RESULTS
  Sixty-one (2.76%) of the 2210 residents in 18 nursing homes were under antibiotic treatment. This rate ranged from 0% to 7.5% among nursing homes. Sixty-two percent of prescriptions complied with recommendations regarding the choice of the drug, and 41.5% could not be improved by choosing an agent with a weaker ecological impact. Globally, 17.8% of prescriptions met all stewardship criteria including re-assessment of the prescription between 48 and 72h after initiation of antibiotic treatment.
  
  
  CONCLUSIONS
  The study results differed. The rate of antibiotic prescription was low in Franche-Comté EHPAD compared to available European data, but antibiotic therapy could be greatly improved. This stresses the need to better train EHPAD physicians for antibiotic stewardship.
authors.affiliation: Pharmacie, centre hospitalier Salins-les-Bains, 39110 Salins-les-Bains, France.
authors.forename: Y
authors.initials: Y
authors.lastname: Boivin
authors.forename: D
authors.initials: D
authors.lastname: Talon
authors.forename: J
authors.initials: J
authors.lastname: Leroy
authors.forename: N
authors.initials: N
authors.lastname: Floret
authors.forename: H
authors.initials: H
authors.lastname: Gbaguidi-Haore
authors.forename: X
authors.initials: X
authors.lastname: Bertrand
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D016470:Bacteremia / Q000188:drug therapy; D003430:Cross-Sectional Studies; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D005602:France / Q000453:epidemiology; D019983:Guideline Adherence; D006707:Homes for the Aged / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008485:Medical Audit; D009735:Nursing Homes / Q000706:statistics & numerical data*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012141:Respiratory Tract Infections / Q000188:drug therapy; D012494:Sampling Studies; D018461:Soft Tissue Infections / Q000188:drug therapy; D011795:Surveys and Questionnaires; D014552:Urinary Tract Infections / Q000188:drug therapy
chemical_list: D000900:Anti-Bacterial Agents