2018
DOI: 10.1017/ice.2018.288
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Antibiotic prescribing upon discharge from the hospital to long-term care facilities: Implications for antimicrobial stewardship requirements in post-acute settings

Abstract: ObjectiveTo quantify the frequency and outcomes of receiving an antibiotic prescription upon discharge from the hospital to long-term care facilities (LTCFs).DesignRetrospective cohort study.SettingA 576-bed, academic hospital in Portland, Oregon.PatientsAdult inpatients (≥18 years of age) discharged to an LTCF between January 1, 2012, and June 30, 2016.MethodsOur primary outcome was receiving a systemic antibiotic prescription upon discharge to an LTCF. We also quantified the association between receiving an … Show more

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Cited by 19 publications
(19 citation statements)
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“…However, we have considered only adequacy with respect to the subsequent microbiological culture, and this is a limitation. In contrast, our patients showed >25% of reconsultations, which is higher than the results obtained in previous studies 11 . This phenomenon can be attributed to a more complex and old population.…”
Section: Discussioncontrasting
confidence: 95%
“…However, we have considered only adequacy with respect to the subsequent microbiological culture, and this is a limitation. In contrast, our patients showed >25% of reconsultations, which is higher than the results obtained in previous studies 11 . This phenomenon can be attributed to a more complex and old population.…”
Section: Discussioncontrasting
confidence: 95%
“…Study data were collected from a longitudinal repository of patients' electronic health record data maintained in partnership with the Oregon Clinical and Translational Institute (OCTRI) Research Data Warehouse. These data have been extensively validated in several previous epidemiologic studies of medication prescribing during transitions of care 12‐15 …”
Section: Methodsmentioning
confidence: 97%
“…The study design and methods of cohort identification have been previously described. 12 Briefly, this was a retrospective cohort study of adult (≥18 years) inpatients discharged from Oregon Health & Science University (OHSU) Hospital to a SNF between January 1, 2017 and December 31, 2018. During the study period, OHSU Hospital was a 576-bed academic, quaternary-care facility in Portland, Oregon.…”
Section: Study Design and Patient Populationmentioning
confidence: 99%
“…Infections often present with atypical symptoms, such as fatigue, confusion, and functional decline . Furthermore, there is a burgeoning population of short‐stay residents in nursing homes receiving post–acute care who often present with higher severity of illness, prevalence of antibiotic use both in the hospital and on discharge, and indwelling devices, increasing the risk of acquisition and infection by multi–drug‐resistant organisms . Beyond challenges in resident characteristics and presentation of infection, there are additional barriers to optimizing antibiotic use in nursing homes, including the frequently fragmented administrative structure in this setting, lack of tools to support empiric antibiotic prescribing, and lack of education regarding guidelines and current evidence to support best practices.…”
Section: Description Of Key Study Findingsmentioning
confidence: 99%