Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Nov 3;48(11-12):512-521.
doi: 10.14745/ccdr.v48i1112a04.

Antibiotic prescribing and antimicrobial stewardship in long-term care facilities: Past interventions and implementation challenges

Niyati Vyas  1 , Tyler Good  2 , Jorida Cila  2 , Mark Morrissey  2 , Denise Gravel Tropper  1
Affiliations

Antibiotic prescribing and antimicrobial stewardship in long-term care facilities: Past interventions and implementation challenges

Niyati Vyas et al. Can Commun Dis Rep. .

Abstract

Background: The threat of antimicrobial resistance (AMR) is rising, leading to increased illness, death and healthcare costs. In long-term care facilities (LTCFs), high rates of infection coupled with high antibiotic use create a selective pressure for antimicrobial-resistant organisms that pose a risk to residents and staff as well as surrounding hospitals and communities. Antimicrobial stewardship (AMS) is paramount in the fight against AMR, but its adoption in LTCFs has been limited.

Methods: This article summarizes factors influencing antibiotic prescribing decisions in LTCFs and the effectiveness of past AMS interventions that have been put in place in an attempt to support those decisions. The emphasis of this literature review is the Canadian LTCF landscape; however, due to the limited literature in this area, the scope was broadened to include international studies.

Results: Prescribing decisions are influenced by the context of the individual patient, their caregivers, the clinical environment, the healthcare system and surrounding culture. Antimicrobial stewardship interventions were found to be successful in LTCFs, though there was considerable heterogeneity in the literature.

Conclusion: This article highlights the need for more well-designed studies that explore innovative and multifaceted solutions to AMS in LTCFs.

Keywords: antibiotic prescribing; antibiotic stewardship; antimicrobial resistance; antimicrobial stewardship; long-term care; long-term care facilities; nursing homes.

PubMed Disclaimer

Conflict of interest statement

Competing interests: The authors report no competing interests.

Figures

Figure 1
Figure 1
Antibiotic prescribing decisions are affected by factors intrinsic and extrinsic to the prescriber Abbreviations: AMS, antimicrobial stewardship; IPAC, infection prevention and control; LTCF, long-term care facility
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Organisation for Economic Co-operation and Development. OECD Health Policy Studies. Stemming the Superbug Tide. Paris (FR): OECD; 2018. https://www.oecd-ilibrary.org/content/publication/9789264307599-en
    1. Arieti F, Göpel S, Sibani M, Carrara E, Pezzani MD, Murri R, Mutters NT, Lòpez-Cerero L, Voss A, Cauda R, Tacconelli E. ARCH working group. White Paper: bridging the gap between surveillance data and antimicrobial stewardship in long-term care facilities—practical guidance from the JPIAMR ARCH and COMBACTE-MAGNET EPI-Net networks. J Antimicrob Chemother 2020;75 Suppl 2:ii42–51. 10.1093/jac/dkaa428 - DOI - PMC - PubMed
    1. Organisation for Economic Co-operation and Development. OECD Health Working Papers. Antimicrobial resistance in long-term care facilities. Paris (FR): OECD; 2022. (accessed 2022-07-15). https://www.oecd-ilibrary.org/social-issues-migration-health/antimicrobi...
    1. Nicolle LE. Antimicrobial stewardship in long term care facilities: what is effective? Antimicrob Resist Infect Control 2014;3(1):6. 10.1186/2047-2994-3-6 - DOI - PMC - PubMed
    1. Penney CC, Boyd SE, Mansfield A, Dalton J, O’Keefe J, Daley PK. Antimicrobial use and suitability in long-term care facilities: A retrospective cross-sectional study. JAMMI 2018;3(4):209–16. 10.3138/jammi.2018-0021 - DOI