Risk of antibiotic overuse in aged care settings

July 21, 2014
Risk of antibiotic overuse in aged care settings

Antibiotics are being overused in residential aged care facilities (RACFs), and more integrated efforts to improve antibiotic prescribing practices need to be introduced, researchers say. 

The study, published in the Medical Journal of Australia, by Monash University researchers found important workflow and culture-related issues that could contribute to in these facilities. Therefore, special attention and guidelines beyond those used in acute-care settings are warranted. 

Dr David Kong, Centre for Medicine Use and Safety, said that the widespread and inappropriate antibiotic use in RACFs had been reported, and was especially concerning given emerging evidence of in these settings. 

"Older people are particularly susceptible to the adverse consequences of antibiotic use, and it is important we look at ways to optimise the use of antibiotics," Dr Kong said.

The study found a number of workflow-related issues in antibiotic prescribing in RACFs, such as a lack of onsite medical doctors and pharmacy supports, nurse-led antibiotic prescribing, and no institutional policy for antibiotic use. 

"We found that antibiotics were commonly prescribed over the phone, which wasn't always followed up with an on-site review, and most visiting GPs tended to prescribe antibiotics early rather than 'waiting and observing'," Dr Kong said. 

"We also found there were mixed opinions on nurse-driven infection management, ranging from GPs with confidence in the nursing assessment to perceiving pressure from nurses to prescribe antibiotics. Nurses themselves reporting lack of knowledge on antibiotic prescribing and quite a number of nurses felt their responsibility in infection management overwhelming. 

"Decisions for are often difficult considering the frailty of elderly patients and many of those with behavioural problems or cognitive deficits. Further, there were often unrealistic expectations from family members to prescribe for minor symptoms or to avert hospitalisation." 

Dr Kong said the findings reflected the need for initiatives to optimise antibiotic use in residential aged , and the next phase was to look at how to collectively improve antibiotic use. 

"This could include further education and training, and introduction of evidence-based guidelines specific to the RACF setting."

Explore further: Antibiotics continue to be prescribed at high rate for bronchitis, contrary to guidelines

More information: "Antibiotic prescribing practice in residential aged care facilities—health care providers' perspectives." Ching Jou Lim, Megan W-L Kwong, Rhonda L Stuart, Kirsty L Buising, N Deborah Friedman, Noleen J Bennett, Allen C Cheng, Anton Peleg, Caroline Marshall and David C M Kong, Med J Aust 2014; 201 (2): 101-105. DOI: 10.5694/mja13.00102

Related Stories

Antibiotics continue to be prescribed at high rate for bronchitis, contrary to guidelines

May 20, 2014
Despite clear evidence of ineffectiveness, guidelines and more than 15 years of educational efforts stating that the antibiotic prescribing rate for acute bronchitis should be zero, the rate was about 70 percent from 1996-2010 ...

High doses of antibiotics may have the potential to promote increased cross-resistance

June 24, 2014
Antibiotic resistance has become an increasing public health concern, with MRSA infections and last lines of antibiotic drug treatments having to be increasingly deployed in hospitals and clinics.

Inappropriate antibiotic use in emergency rooms not decreasing in adults

January 9, 2014
An analysis of emergency room (ER)visits over a 10-year period finds that while inappropriate antibiotic use is decreasing in pediatric settings, it continues to remain a problem in adults, according to an article published ...

Physicians need to be prepared to talk antibiotics

February 7, 2014
(HealthDay)—Patient pressure to receive antibiotic prescriptions remains a challenge for providers who are trying to combat antibiotic resistance by curbing prescriptions for viral infections, according to an article published ...

Antibiotic use prevalent in hospice patients despite limited evidence of its value

July 14, 2014
New research suggests that use of antibiotics is still prevalent among terminal patients who have chosen hospice care as an end-of-life option, despite little evidence that the medications improve symptoms or quality of life, ...

Study shows why doctors over-prescribe antibiotics

March 28, 2014
(Medical Xpress)—New research from a University of Queensland sociologist shows many doctors over-prescribe antibiotics because they want the best outcomes for individual patients.

Recommended for you

Mind-body therapies immediately reduce unmanageable pain in hospital patients

July 25, 2017
Mindfulness training and hypnotic suggestion significantly reduced acute pain experienced by hospital patients, according to a new study published in the Journal of General Internal Medicine.

Study suggests ending opioid epidemic will take years

July 20, 2017
The question of how to stem the nation's opioid epidemic now has a major detailed response. A new study chaired by University of Virginia School of Law Professor Richard Bonnie provides extensive recommendations for curbing ...

Team-based model reduces prescription opioid use among patients with chronic pain by 40 percent

July 17, 2017
A new, team-based, primary care model is decreasing prescription opioid use among patients with chronic pain by 40 percent, according to a new study out of Boston Medical Center's Grayken Center for Addiction Medicine, which ...

Private clinics' peddling of unproven stem cell treatments is unsafe and unethical

July 7, 2017
Stem cell science is an area of medical research that continues to offer great promise. But as this week's paper in Science Translational Medicine highlights, a growing number of clinics around the globe, including in Australia, ...

Popular heartburn drugs linked to higher death risk

July 4, 2017
Popular heartburn drugs called proton pump inhibitors (PPIs) have been linked to a variety of health problems, including serious kidney damage, bone fractures and dementia. Now, a new study from Washington University School ...

Most reproductive-age women using opioids also use another substance

June 30, 2017
The majority of reproductive-age and pregnant women who use opioids for non-medical purposes also use at least one other substance, ranging from nicotine or alcohol to cocaine, according to a University of Pittsburgh Graduate ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.