Optimizing Antibiotic Stewardship in Nursing Homes: A Narrative Review and Recommendations for Improvement

被引：99

作者：

Crnich, Christopher J. ^{[1
,2
]}

Jump, Robin ^{[3
,4
]}

Trautner, Barbara ^{[5
,6
]}

Sloane, Philip D. ^{[7
,8
]}

Mody, Lona ^{[9
,10
]}

机构：

[1] Univ Wisconsin, Sch Med & Publ Hlth, Madison, WI 53705 USA

[2] William S Middleton Vet Affairs Hosp, Madison, WI USA

[3] Vet Affairs Med Ctr, Louis Stokes Cleveland Dept, Geriatr Res Educ & Clin Ctr, Div Internal Med, Cleveland, OH USA

[4] Case Western Reserve Univ, Dept Med, Div Infect Dis, Cleveland, OH 44106 USA

[5] Baylor Coll Med, Dept Med, Infect Dis Sect, Houston, TX 77030 USA

[6] Michael E DeBakey VA Med Ctr, Ctr Innovat Qual Effectiveness & Safety, Houston, TX USA

[7] Univ N Carolina, Cecil G Sheps Ctr Hlth Serv Res, Chapel Hill, NC USA

[8] Univ N Carolina, Dept Family Med, Chapel Hill, NC 27514 USA

[9] Univ Michigan, Div Geriatr & Palliat Care Med, Ann Arbor, MI 48109 USA

[10] Vet Affairs Ann Arbor Healthcare Syst, Geriatr Res Educ & Clin Ctr, Ann Arbor, MI USA

来源：

DRUGS & AGING | 2015年 / 32卷 / 09期

基金：

美国国家卫生研究院; 美国医疗保健研究与质量局;

关键词：

TERM-CARE FACILITIES; URINARY-TRACT-INFECTIONS; RESISTANT STAPHYLOCOCCUS-AUREUS; CLOSTRIDIUM-DIFFICILE INFECTION; ADVERSE DRUG EVENTS; QUALITY-OF-CARE; ANTIMICROBIAL STEWARDSHIP; ASYMPTOMATIC BACTERIURIA; METHICILLIN-RESISTANT; EDUCATIONAL INTERVENTION;

D O I：

10.1007/s40266-015-0292-7

中图分类号：

R592 [老年病学]; C [社会科学总论];

学科分类号：

03 ; 0303 ; 100203 ;

摘要：

The emerging crisis in antibiotic resistance and concern that we now sit on the precipice of a post-antibiotic era have given rise to advocacy at the highest levels for widespread adoption of programmes that promote judicious use of antibiotics. These antibiotic stewardship programmes, which seek to optimize antibiotic choice when clinically indicated and discourage antibiotic use when clinically unnecessary, are being implemented in an increasing number of acute care facilities, but their adoption has been slower in nursing homes. The antibiotic prescribing process in nursing homes is fundamentally different from that observed in hospital and clinic settings, with formidable challenges to implementation of effective antibiotic stewardship. Nevertheless, an emerging body of research points towards ways to improve antibiotic prescribing practices in nursing homes. This review summarizes the findings of this research and presents ways in which antibiotic stewardship can be implemented and optimized in the nursing home setting.

引用

页码：699 / 716

页数：18

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