title: Surveillance of antimicrobial use in Dutch long-term care facilities.
abstract: : Residents living in a long-term care facility (LTCF) are more susceptible to infections. Treatment with antimicrobials is sometimes necessary; however, antibiotic use is considered one of the most important drivers of the development of antibiotic resistance. Surveillance data on antibiotic use in these LTCFs are necessary to get more insight into these patterns. The objective of this study was to describe antibiotic use in LTCFs in the Netherlands.
  
  
  
  : One hundred and seventy-seven LTCFs in the Netherlands were contacted and asked to participate in a study concerning antibiotic resistance and antibiotic use. Associated pharmacies were asked to provide data about systemic antibiotic use for each participating LTCF location over 1 year. Results on antibiotic use are reported here.
  
  
  
  : Antibiotic use data from 96 LTCFs were collected from the pharmacies, and 68 of these LTCFs completed additional questionnaires on general characteristics of their location. Mean total use of systemic antimicrobials was 73 DDDs/1000 residents per day (range 2-197 DDDs/1000 residents per day). Co-amoxiclav (23 DDDs/1000 residents/day, range 0-70) was used the most, followed by nitrofurantoin derivatives (12 DDDs/1000 residents/day, range 0-38) and fluoroquinolones (12 DDDs/1000 residents/day, range 0-52). Statistical analysis revealed no significant correlations between the LTCF characteristics and the level of antibiotic use.
  
  
  
  There was a high use of broad-spectrum antimicrobials, with a large variation in total antibiotic use between individual locations. Further analysis of more in-depth data and possible influencing factors is needed.
authors.affiliation: Department of Pharmacy, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Monique
authors.initials: M
authors.lastname: Roukens
authors.affiliation: National Institute for Public Health and the Environment (RIVM)/CIb, Bilthoven, The Netherlands.
authors.forename: Linda
authors.initials: L
authors.lastname: Verhoef
authors.affiliation: National Institute for Public Health and the Environment (RIVM)/CIb, Bilthoven, The Netherlands.
authors.forename: Ellen
authors.initials: E
authors.lastname: Stobberingh
authors.affiliation: Department of Pharmacy, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Natsch
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019980:Amoxicillin-Potassium Clavulanate Combination / Q000008:administration & dosage / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D000890:Anti-Infective Agents / Q000627:therapeutic use; D004333:Drug Administration Routes; D024881:Drug Resistance, Bacterial; D062665:Epidemiological Monitoring; D004926:Escherichia coli / Q000187:drug effects; D005260:Female; D024841:Fluoroquinolones / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D009735:Nursing Homes; D010594:Pharmacies; D013211:Staphylococcus aureus / Q000187:drug effects; D011795:Surveys and Questionnaires
chemical_list: D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D024841:Fluoroquinolones; D019980:Amoxicillin-Potassium Clavulanate Combination