Preventive Antibiotic Use in Nursing Homes: A Not Uncommon Reason for Antibiotic Overprescribing

Sloane, Philip D.; Tandan, Meera; Zimmerman, Sheryl

doi:10.1016/j.jamda.2020.07.026

Cited by 7 publications

(4 citation statements)

References 39 publications

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“…1 Although only 2% to 10% of ARS is bacterial in origin, physicians frequently prescribe antibiotics over 50% of the time. [2][3][4][5] The judicious usage of antibiotics in ARS treatment plans is essential for mitigating antimicrobial resistance, limiting idiosyncratic adverse events related to antibiotics, and improving patient outcomes more broadly.…”

Section: Introductionmentioning

confidence: 99%

Antibiotic Prescribing for Acute Rhinosinusitis: In‐Person Versus Virtual Visits During Covid‐19

Miller

Bhattacharyya

2020

The Laryngoscope

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Objectives/Hypothesis: Determine if antibiotic prescribing patterns differ for in-person versus virtual clinic visits for acute rhinosinusitis (ARS).Study Design: Cross sectional study. Methods: All adult virtual clinical encounters from March to May 2020 with a principal diagnosis of ARS were reviewed for demographic data and the presence or absence of an antibiotic prescription during the coronavirus shut down in Massachusetts. In-person clinical encounters from March to May 2019 were similarly examined as a control. The rate of antibiotic prescription was compared between virtual (2020) and in-person ( 2019) visits for ARS diagnoses.Results: There were 2,075 patients in March to May 2020 and 3,654 patients March to May 2019 who received an ARS principal diagnosis at their virtual and in-person outpatient visits, respectively. There was a statistically significant lower rate of antibiotic prescriptions for ARS in 2020 (72.1%) versus 2019 (76.7%).The odds ratio for an antibiotic prescription for ARS was 0.783 (95% confidence interval, 0.693-0.86; P < .001) for patients seen in the 2020 cohort versus the 2019 cohort. The compared rates for antibiotic prescribing for 2020 versus 2019 were not different in individual month-to-month comparisons. When stratified by otolaryngology providers there was no statistically significant difference of antibiotic prescriptions between the 2019 and 2020 cohort (P = .781).Conclusions: During the massive transition to virtual visits for March to May 2020 due to the coronavirus pandemic shut down in Massachusetts, the total rate of outpatient antibiotic prescribing for ARS was lower in the virtual visit environment compared to the traditional in-person visit. In this scenario, telemedicine did not result in an increase in antibiotic prescribing despite the lack of an in-person physical exam.

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Section: Introductionmentioning

confidence: 99%

Antibiotic Prescribing for Acute Rhinosinusitis: In‐Person Versus Virtual Visits During Covid‐19

Miller

Bhattacharyya

2020

The Laryngoscope

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“…The literature does describe a series of infections, including UTIs, that have been treated prophylactically as an acceptable practice. Targeted approaches in these cases would seem most efficacious and appropriate to counteract unnecessary antibiotic treatment stemming from outdated accepted practices (Sloane et al, 2020a). Although UTIs are common in NHs, it is important to target other infections, such as skin or soft tissue infections where similar to UTIs, antibiotics are commonly used for prophylactic purposes for recurrent infections (Sloane et al, 2020b).…”

Section: Discussionmentioning

confidence: 99%

Antimicrobial Stewardship Interventions to Optimize Treatment of Infections in Nursing Home Residents: A Systematic Review and Meta-Analysis

et al. 2021

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Effects of antibiotic stewardship program (ASP) interventions to optimize antibiotic use for infections in nursing home (NH) residents remain unclear. The aim of this systematic review and meta-analysis was to assess ASPs in NHs and their effects on antibiotic use, multi-drug-resistant organisms, antibiotic prescribing practices, and resident mortality. Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, we conducted a systematic review and meta-analysis using five databases (1988–2020). Nineteen articles were included, 10 met the criteria for quantitative synthesis. Inappropriate antibiotic use decreased following ASP intervention in eight studies with a pooled decrease of 13.8% (95% confidence interval [CI]: [4.7, 23.0]; Cochran’s Q = 166,837.8, p < .001, I2 = 99.9%) across studies. Decrease in inappropriate antibiotic use was highest in studies that examined antibiotic use for urinary tract infection (UTI). Education and antibiotic stewardship algorithms for UTI were the most effective interventions. Evidence surrounding ASPs in NH is weak, with recommendations suited for UTIs.

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“…In nursing homes, a significant number of systemic antibiotics are used for prophylactic purposes against bacterial infections. This leads to serious adverse effects and the emergence of AMR ( Sloane et al, 2020 ). In veterinary medicines the use of antimicrobials are very extensive for prophylactic purposes ( Odoi et al, 2021 ).…”

Section: Driving Factors For Antibiotic Resistancementioning

confidence: 99%

Extensively and multidrug-resistant bacterial strains: case studies of antibiotics resistance

Almutairy

2024

Front. Microbiol.

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The development of antibiotic resistance compromises the effectiveness of our most effective defenses against bacterial infections, presenting a threat to global health. To date, a large number of research articles exist in the literature describing the case reports associated with extensively drug-resistant (XDR) and multidrug-resistant (MDR) bacterial strains. However, these findings are scattered, making it time-consuming for researchers to locate promising results and there remains a need for a comparative study to compile these case reports from various geographical regions including the Kingdom of Saudi Arabia. Additionally, no study has yet been published that compares the genetic variations and case reports of MDR and XDR strains identified from Saudi Arabia, the Middle East, Central Europe, and Asian countries. This study attempts to provide a comparative analysis of several MDR and XDR case reports from Saudi Arabia alongside other countries. Furthermore, the purpose of this work is to demonstrate the genetic variations in the genes underlying the resistance mechanisms seen in MDR and XDR bacterial strains that have been reported in Saudi Arabia and other countries. To cover the gap, this comprehensive review explores the complex trends in antibiotic resistance and the growing risk posed by superbugs. We provide context on the concerning spread of drug-resistant bacteria by analyzing the fundamental mechanisms of antibiotic resistance and looking into individual case reports. In this article, we compiled various cases and stories associated with XDR and MDR strains from Saudi Arabia and various other countries including China, Egypt, India, Poland, Pakistan, and Taiwan. This review will serve as basis for highlighting the growing threat of MDR, XDR bacterial strains in Saudi Arabia, and poses the urgent need for national action plans, stewardship programs, preventive measures, and novel antibiotics research in the Kingdom.

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Preventive Antibiotic Use in Nursing Homes: A Not Uncommon Reason for Antibiotic Overprescribing

Cited by 7 publications

References 39 publications

Antibiotic Prescribing for Acute Rhinosinusitis: In‐Person Versus Virtual Visits During Covid‐19

Antibiotic Prescribing for Acute Rhinosinusitis: In‐Person Versus Virtual Visits During Covid‐19

Antimicrobial Stewardship Interventions to Optimize Treatment of Infections in Nursing Home Residents: A Systematic Review and Meta-Analysis

Extensively and multidrug-resistant bacterial strains: case studies of antibiotics resistance

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