Too Many Antibiotics, Not Enough Sanitation in Nursing Homes
The overuse of antibiotics is a serious problem in nursing homes. Over the course of a year, 50% to 70% of nursing home residents receive antibiotics. Up to 75% of antibiotics in nursing homes are prescribed incorrectly, as reported by the Centers for Disease Control and Prevention (CDC). To address this problem, the CDC has released its Antimicrobial Stewardship Guide, with toolkits to help nursing homes optimize their use of antibiotics.
Prescribing Problems with Antibiotics in Nursing Homes
According to the CDC, the most common prescribing problems with antibiotics in nursing homes are:
- Using antibiotics when they are not needed
- Prescribing the wrong antibiotic
- Using the correct antibiotic, but in the wrong dose or the wrong duration
Antibiotic-prescribing problems can lead to harmful side effects in seniors. These include allergic reactions, antibiotic-resistant infections, and C. difficile infections, caused by toxin-producing bacteria that lead to severe antibiotic-associated diarrhea.
CDC researchers examined medical records of nine different nursing homes in four different states over a six-month period to assess antibiotic use. They found that:
- 11% of nursing home residents were on antibiotics in any given day.
- One in three antibiotic prescriptions was for the treatment of urinary tract infections.
- 50% or more of these prescriptions were for the wrong drug, the wrong dose, or the wrong duration.
- 38% of orders for antibiotics lacked documentation of one or more important prescribing elements.
Better Sanitation Can Reduce the Use of Antibiotics in Nursing Homes
Researchers addressed the problem of common infections in nursing homes in a study published in Aging Health. This study reports that more than 1.5 million people living in 16,000 U.S. nursing homes experience an average of 2 million infections per year. Infections and antibiotic-resistant organisms are a serious challenge in nursing homes, where the residents are older and frailer, and antibiotic overuse is rampant. Researchers found that better sanitation can help reduce the emergence of antibiotic-resistant organisms and the incidence of infections.
- Pneumonia: Respiratory tract infections and pneumonia are the leading causes of mortality in nursing homes. Annual immunizations against influenza in older adults and their healthcare workers has been shown to reduce mortality among residents. Dental plaque has been studied as a source of bacteria that may cause respiratory infections. Studies have shown that better oral hygiene has positive preventative effects for pneumonia and respiratory tract infections.
- Urinary tract infections: Many urinary tract infections (UTIs) in nursing homes are associated with the use of catheters. Guidelines to help prevent UTIs include limiting the use of catheters, minimizing the duration of use, using aseptic techniques to insert catheters, and diligent hand hygiene by caregivers before and after manipulation of a catheter.
- Diarrhea: Older adults have decreased production of gastric acid, putting them at higher risk for diarrheal infections, which can be fatal in the elderly. To prevent these serious infections, the CDC recommends using Environmental Protection Agency-registered disinfectants with sporicidal capabilities, along with appropriate hand hygiene with soap and water to remove spores from skin surfaces.
- Skin and soft tissue infections: Topical applications of medications, properly administered, along with patient isolation, proper cleaning and disinfection, clipping long nails, glove use, and proper hand hygiene can help treat and prevent these infections from spreading and reduce the need for antibiotics.
If your elderly loved one has suffered harm from misuse of antibiotics in a nursing home, contact The Sorey Law Firm P.L.L.C. at (903) 212-2822. Our practice is devoted exclusively to injured people.
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