Optimizing antibiotics in residents of nursing homes: Protocol of arandomized trial

Mark Loeb*, Kevin Brazil, Lynne Lohfeld, Allison McGeer, Andrew Simor, Kurt Stevenson, Stephen Walter, Dick Zoutman

*Corresponding author for this work

Research output: Contribution to journalArticle

37 Citations (Scopus)

Abstract

Background: Antibiotics are frequently prescribed for older adults who reside in long-term care facilities. A substantial proportion of antibiotic use in this setting is inappropriate. Antibiotics are often prescribed for asymptomatic bacteriuria, a condition for which randomized trials of antibiotic therapy indicate no benefit and in fact harm. This proposal describes a randomized trial of diagnostic and therapeutic algorithms to reduce the use of antibiotics in residents of long-term care facilities. Methods: In this on-going study, 22 nursing homes have been randomized to either use of algorithms (11 nursing homes) or to usual practise (11 nursing homes). The algorithms describe signs and symptoms for which it would be appropriate to send urine cultures or to prescribe antibiotics. The algorithms are introduced by inservicing nursing staff and by conducting one-on-one sessions for physicians using case-scenarios. The primary outcome of the study is courses of antibiotics per 1000 resident days. Secondary outcomes include urine cultures sent and antibiotic courses for urinary indications. Focus groups and semi-structured interviews with key informants will be used to assess the process of implementation and to identify key factors for sustainability.

Original languageEnglish
Article number1
Pages (from-to)17
Number of pages6
JournalBMC health services research
Volume2
Issue number1
DOIs
Publication statusPublished - 03 Sep 2002
Externally publishedYes

Bibliographical note

Copyright 2008 Elsevier B.V., All rights reserved.

ASJC Scopus subject areas

  • Health Policy

Fingerprint Dive into the research topics of 'Optimizing antibiotics in residents of nursing homes: Protocol of arandomized trial'. Together they form a unique fingerprint.

Cite this