Challenges in Tracking and Reporting Antibiotic Use in Long-Term Care |
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| Institution: | 1. Insight Therapeutics, Norfolk, VA;2. Clinical Internal Medicine, Eastern Virginia Medical School, Norfolk, VA;3. Geriatric Research Education and Clinical Center (GRECC), VA Northeast Ohio Healthcare System, Cleveland, OH;4. Division of Infectious Diseases and HIV Medicine, Department of Medicine and Department of Epidemiology and Biostatistics, Case Western Reserve University School of Medicine, Cleveland, OH;1. Department of Rehabilitation, Tamura Surgical Hospital, Kawasaki-shi, Kanagawa, Japan;2. Department of Rehabilitation Medicine, Mie University Graduate School of Medicine, Tsu-shi, Mie, Japan;3. Center for Preventive Medical Sciences, Chiba University, Chiba-shi, Chiba, Japan;4. Department of Pharmacy, Tosei General Hospital, Seto-shi, Aichi, Japan;5. Department of Geriatric Medicine, National Center for Geriatrics and Gerontology, Obu-shi, Aichi, Japan;1. Videbimus Clinic Research Center, Tokyo, Japan;2. Department of Primary Care and Population Health, University College London, London, United Kingdom;3. Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan;4. Center for Health and Environmental Risk Research, National Institute for Environmental Studies, Tsukuba, Japan;1. Centre on Aging and Mobility, University Hospital Zurich, Waid City Hospital, and University of Zurich, Zurich, Switzerland;2. Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA;3. Department of Geriatrics, University Hospital Zurich, Zurich, Switzerland;4. University Clinic for Acute Geriatric Care, Waid City Hospital, Zurich, Switzerland;1. Service of Geriatric Medicine and Geriatric Rehabilitation, University of Lausanne Hospital Center, Lausanne, Switzerland;2. Specialization School in Geriatrics, University of Milan, Milan, Italy;3. Health Services Unit, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland |
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| Abstract: | The contemporary long-term care provider and interdisciplinary team are well aware of the recent focus on antibiotic use in their settings. Regulatory changes implemented by Centers for Medicare and Medicaid Services beginning in 2016 have required long-term care settings to look at antibiotic use in a more comprehensive way and to align their programs with the Centers for Disease Control and Prevention's Core Elements for Antibiotic Stewardship for Nursing Homes. As long-term care settings have worked to develop antibiotic stewardship programs over the past several years, there have been many discoveries about the processes involved in gathering data about antibiotic use and associated attributes, including dose, duration of therapy, and indication for use. Attempts to align these attributes with appropriateness may require integration of data elements from pharmacy records and the individual resident's electronic medical record. In this article, we systematically discuss relevant antibiotic use metrics, sources of antibiotic use data, collecting and reporting antibiotic use data, concluding with implications for policy, practice, and research. Only by measuring antibiotic use can we start to assess the effectiveness of antibiotic stewardship program to induce meaningful change in the care of residents in long-term care. |
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| Keywords: | Nursing home antibiotic use medication use evaluation antibiotic stewardship long-term care pharmacy |
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