Three years of antibiotic consumption evaluation in French nursing homes

Marquet, A.; Thibaut, S.; LePabic, E.; Huon, Jean‐François; Ballereau, F.

doi:10.1016/j.medmal.2015.05.006

Cited by 7 publications

(9 citation statements)

References 7 publications

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“…Co-amoxiclav and fluoroquinolones are broad-spectrum antibiotics which have been linked to side-effects including Clostridium difficile infections and antimicrobial resistance [ 22 - 24 ]. The same pattern of co-amoxiclav followed by fluoroquinolones as the most commonly prescribed antibiotics was found in a French study [ 10 ]. In the HALT and HALT-2 studies, most patients received penicillins variously co-prescribed with co-amoxiclav, other antibacterials (J01X, mostly nitrofurantoin) and fluoroquinolones.…”

Section: Discussionsupporting

confidence: 75%

“…The first step towards improved antimicrobial prescribing is to analyse the current patterns of antimicrobial use. Several studies on antimicrobial use in LTCFs have been published in the past few years, but with some exceptions [ 6 - 10 ], the studies included relatively few LTCFs from one country. Slovenia was included in the Healthcare-Associated Infections in Long-Term Care Facilities Project (HALT) in 2010 with six LTCFs and in the 2013 HALT-2 study with four LTCFs; in the latter study the Slovenian LTCF sample was not representative [ 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

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Antimicrobial prescribing in long-term care facilities: a nationwide point-prevalence study, Slovenia, 2016

et al. 2018

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Residents in long-term care are at high risk of infections because of their old age and many related health problems that lead to frequent antibiotic prescribing. The aim of the study was to assess antibiotic use in Slovenian long-term care facilities (LTCFs). The point-prevalence study was conducted between April and June 2016. Online questionnaires were sent to all Slovenian LTCFs. Eighty (68.4%) of the 117 LTCFs contacted, caring for 13,032 residents (70.6% of all Slovenian LTCF residents), responded to the survey. On the day of the study, the mean antibiotic prevalence per LTCF was 2.4% (95% confidence interval: 1.94–2.66). Most (70.2%) of the residents taking antibiotics were female. Most residents were being treated for respiratory tract (42.7%) or urinary tract (33.3%) infections. Co-amoxiclav and fluoroquinolones were the most frequently prescribed antibiotics (41.0% and 22.3% respectively). Microbiological tests were performed for 5.2% of residents receiving antibiotics. Forty nine (19.8%) residents receiving antibiotics were colonised with multidrug-resistant bacteria (MDR). Antibiotic use in Slovenian LTCFs is not very high, but most prescribed antibiotics are broad-spectrum. Together with low use of microbiological testing and high prevalence of colonisation with MDR bacteria the situation is worrisome and warrants the introduction of antimicrobial stewardship interventions.

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Section: Discussionsupporting

confidence: 75%

Section: Introductionmentioning

confidence: 99%

Antimicrobial prescribing in long-term care facilities: a nationwide point-prevalence study, Slovenia, 2016

et al. 2018

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“…14,21,22 Results from the present study suggest that the antibacterial use and variability in the LTCFs of the canton of Vaud are similar to those observed in other European and North American LTCFs. The aggregate antibacterial use rates in LTCFs of the canton of Vaud in 2016 were lower than those reported by Marquet et al for 74 French LTCFs, which had a total antibacterial use of 44.8 DDD per 1000 patient-days in 2013, 23 but were higher than those reported in studies from Nordic European countries. 24,25 Indeed, a cross-sectional descriptive study by Blix et al showed a median of 14.8 DDD/100 bed-days in 133 Norwegian LTCFs.…”

Section: Discussioncontrasting

confidence: 59%

Decrease in Antibacterial Use and Facility-Level Variability After the Introduction of Guidelines and Implementation of Physician-Pharmacist-Nurse Quality Circles in Swiss Long-term Care Facilities

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et al. 2020

Journal of the American Medical Directors Association

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“…Fourteen studies reported a range from 2.1 to 13.0 antibiotic courses per 1000 resident days [ 8 , 30 , 40 , 56 , 70 , 73 , 80 , 90 , 93 , 95 , 107 , 109 , 111 , 112 ]. Finally, 15 studies reported a range of 38.2 to 148 DDD/1000 bed days [ 8 , 41 , 53 , 55 , 67 , 74 , 79 , 82 – 84 , 88 , 89 , 92 , 102 , 106 ]. Details are provided in S8 File .…”

Section: Resultsmentioning

confidence: 99%

“…As a result of this national regulation, quinolone use in Australian LTCFs is low, despite overall antibiotic use in Australian LTCFs being high compared to other regions. A positive finding with respect to antibiotics on the WHO Watch List was that macrolides were reported to be among the three most frequently prescribed antibiotics in only four studies, one from France [ 74 ], one from the US [ 40 ], and two from Japan [ 67 , 100 ].…”

Section: Discussionmentioning

confidence: 99%

Temporal and regional trends of antibiotic use in long-term aged care facilities across 39 countries, 1985-2019: Systematic review and meta-analysis

et al. 2021

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Background Antibiotic misuse is a key contributor to antimicrobial resistance and a concern in long-term aged care facilities (LTCFs). Our objectives were to: i) summarise key indicators of systemic antibiotic use and appropriateness of use, and ii) examine temporal and regional variations in antibiotic use, in LTCFs (PROSPERO registration CRD42018107125). Methods & findings Medline and EMBASE were searched for studies published between 1990–2021 reporting antibiotic use rates in LTCFs. Random effects meta-analysis provided pooled estimates of antibiotic use rates (percentage of residents on an antibiotic on a single day [point prevalence] and over 12 months [period prevalence]; percentage of appropriate prescriptions). Meta-regression examined associations between antibiotic use, year of measurement and region. A total of 90 articles representing 78 studies from 39 countries with data between 1985–2019 were included. Pooled estimates of point prevalence and 12-month period prevalence were 5.2% (95% CI: 3.3–7.9; n = 523,171) and 62.0% (95% CI: 54.0–69.3; n = 946,127), respectively. Point prevalence varied significantly between regions (Q = 224.1, df = 7, p<0.001), and ranged from 2.4% (95% CI: 1.9–2.7) in Eastern Europe to 9.0% in the British Isles (95% CI: 7.6–10.5) and Northern Europe (95% CI: 7.7–10.5). Twelve-month period prevalence varied significantly between regions (Q = 15.1, df = 3, p = 0.002) and ranged from 53.9% (95% CI: 48.3–59.4) in the British Isles to 68.3% (95% CI: 63.6–72.7) in Australia. Meta-regression found no association between year of measurement and antibiotic use prevalence. The pooled estimate of the percentage of appropriate antibiotic prescriptions was 28.5% (95% CI: 10.3–58.0; n = 17,245) as assessed by the McGeer criteria. Year of measurement was associated with decreasing appropriateness of antibiotic use over time (OR:0.78, 95% CI: 0.67–0.91). The most frequently used antibiotic classes were penicillins (n = 44 studies), cephalosporins (n = 36), sulphonamides/trimethoprim (n = 31), and quinolones (n = 28). Conclusions Coordinated efforts focusing on LTCFs are required to address antibiotic misuse in LTCFs. Our analysis provides overall baseline and regional estimates for future monitoring of antibiotic use in LTCFs.

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Three years of antibiotic consumption evaluation in French nursing homes

Cited by 7 publications

References 7 publications

Antimicrobial prescribing in long-term care facilities: a nationwide point-prevalence study, Slovenia, 2016

Antimicrobial prescribing in long-term care facilities: a nationwide point-prevalence study, Slovenia, 2016

Decrease in Antibacterial Use and Facility-Level Variability After the Introduction of Guidelines and Implementation of Physician-Pharmacist-Nurse Quality Circles in Swiss Long-term Care Facilities

Temporal and regional trends of antibiotic use in long-term aged care facilities across 39 countries, 1985-2019: Systematic review and meta-analysis

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