title: Antimicrobial use in Hungarian long-term care facilities: high proportion of quinolone antibacterials.
abstract: The aim of this survey was to estimate the burden of antimicrobial use and to describe the determinants for antimicrobial use in Hungarian long-term care facilities (LTCFs) in order to increase the attention given to the proper prescription for this vulnerable population. A one-day point-prevalence study was undertaken between April and May 2013. Data on resident treated with an antibacterial, antimycotic or tuberculostatic for systemic use were collected prospectively on a single day in each participating LTCF with over 50 beds. Descriptive statistics were used to present the data. 91 LTCFs with 11,823 residents participated in this survey. 156 residents (1.3%) were given antimicrobials. 96.8% of antimicrobials were mostly prescribed for therapy included urinary tract infections (40.3%), respiratory tract infections (38.4%) and skin and soft tissue infections (13.2%). The most common therapeutic antimicrobials (97.5%) belonged to the ATC J01 class of 'antibacterials for systemic use'. The most important J01 subclasses were J01M quinolone antibacterials (32.7%), J01C beta-lactam antibacterials (25.2%), J01D other beta-lactam antibacterials (11.3%) and J01F macrolides, lincosamides and streptogramins (11.3%). Antimicrobials were mostly prescribed empirically whereas 3.8% was microbiologically documented treatments. 3.2% of all prescribed antimicrobials were prescribed for the prophylaxis of urinary tract infections (60%) and ear, nose, mouth infections (40%). Our results emphasize the need of a national recommendation for good practice in LTCFs in order to avoid inappropriate antimicrobial therapy leading to spread of multidrug resistant pathogens. In addition, continuing education of prescribers on antimicrobial treatment is essential.
authors.affiliation: National Centre for Epidemiology, Department of Hospital Epidemiology, Albert Flórián út 2-6, H-1097 Budapest, Hungary. Electronic address: szabo.rita@oek.antsz.hu.
authors.forename: Rita
authors.initials: R
authors.lastname: Szabó
authors.affiliation: National Centre for Epidemiology, Department of Hospital Epidemiology, Albert Flórián út 2-6, H-1097 Budapest, Hungary.
authors.forename: Karolina
authors.initials: K
authors.lastname: Böröcz
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006814:Hungary; D008134:Long-Term Care; D008297:Male; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D015995:Prevalence; D011446:Prospective Studies; D015363:Quinolones / Q000627:therapeutic use*; D011795:Surveys and Questionnaires
chemical_list: D000900:Anti-Bacterial Agents; D015363:Quinolones
keywords: Antimicrobial use; Elderly residents; Long-term care facilities; Point-prevalence survey