Antibiotic Use Among Residents Receiving Skilled Nursing Care in 29 U.S. Nursing Homes
BACKGROUND Data describing antibiotic use in U.S. nursing homes remain limited. We report antibiotic use among skilled nursing facility residents from 29 U.S. nursing homes and assessed correlations between antibiotics prescribed to residents in skilled care and nursing home characteristics. DESIGN...
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| Veröffentlicht in: | Journal of the American Geriatrics Society (JAGS) 2021-02, Vol.69 (2), p.399-406 |
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| container_title | Journal of the American Geriatrics Society (JAGS) |
| container_volume | 69 |
| creator | Song, Sunah Wilson, Brigid M. Bej, Taissa Gravenstein, Stefan Carter, Rebecca R. Marek, Joseph Jump, Robin L. P. |
| description | BACKGROUND
Data describing antibiotic use in U.S. nursing homes remain limited. We report antibiotic use among skilled nursing facility residents from 29 U.S. nursing homes and assessed correlations between antibiotics prescribed to residents in skilled care and nursing home characteristics.
DESIGN
Retrospective cohort study.
SETTING
Twenty‐nine U.S. nursing homes in the same healthcare corporation.
PARTICIPANTS
Residents receiving skilled care in 2016.
MEASUREMENTS
We used pharmacy invoice and nursing home census data to calculate the days of antibiotic therapy per 1,000 days of skilled care (1,000 DOSC), the rate of antibiotic starts per 1,000 DOSC, the length of antibiotic therapy, and the average antibiotic spectrum index. We also assessed correlations between antibiotic use and nursing home characteristics.
RESULTS
Antibiotics accounted for an average of 9.6% (±0.6%) of systemic medications prescribed among residents receiving skilled care. On average, 26.8% (±2.9%) of antibiotics were intravenous. Fluoroquinolones were prescribed at the highest rates (19% across all facilities), followed by beta‐lactam/beta‐lactamase inhibitors (11%), first‐ and second‐generation cephalosporins, sulfonamides, and oral tetracyclines (each at 9%). Both the proportion of residents using enrolled in Medicare and number of unique prescribers responsible for systemic prescriptions positively correlated with the rate of antibiotic starts.
CONCLUSIONS
Our study demonstrates that pharmacy invoices represent a useful and preexisting source of data for assessing antibiotic prescriptions among individuals receiving skilled nursing care. The correlation between the number of unique prescribers and antibiotic starts suggests that prescribers are central to efforts to improve antibiotic use in nursing homes. |
| doi_str_mv | 10.1111/jgs.16856 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2449962441</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2484689501</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3536-1f0788f4b247b24b445fc83e7ea207cf7489779dc7d10fba63f09d5b02c107c73</originalsourceid><addsrcrecordid>eNp1kF9LwzAUxYMobk4f_AJS8EUf2iVN2qSPY-imDAXnfA1tejsy-2cmq7Jvb2bnHgQDN_fm3B-HcBC6JDgg7gxXSxuQWETxEeqTiIZ-xEh0jPoY49AXMWE9dGbtCmMSYiFOUY9STHlMaB-9jeqNznSz0cpbWPBGVVMvvRewOod6Y92kQH9qp83fdVlC7j21xu7e49SAp2svTLxFMA8O-rSpwJ6jkyItLVzs-wAt7u9ex1N_9jx5GI9mvqIRjX1SYC5EwbKQcVcZY1GhBAUOaYi5KjgTCedJrnhOcJGlMS1wkkcZDhVxe04H6KbzXZvmowW7kZW2CsoyraFprQwZS5LY3cSh13_QVdOa2v3OUYLFIonwjrrtKGUaaw0Ucm10lZqtJFjuwpYubPkTtmOv9o5tVkF-IH_TdcCwA750Cdv_neTjZN5ZfgOByIXR</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2484689501</pqid></control><display><type>article</type><title>Antibiotic Use Among Residents Receiving Skilled Nursing Care in 29 U.S. Nursing Homes</title><source>Access via Wiley Online Library</source><creator>Song, Sunah ; Wilson, Brigid M. ; Bej, Taissa ; Gravenstein, Stefan ; Carter, Rebecca R. ; Marek, Joseph ; Jump, Robin L. P.</creator><creatorcontrib>Song, Sunah ; Wilson, Brigid M. ; Bej, Taissa ; Gravenstein, Stefan ; Carter, Rebecca R. ; Marek, Joseph ; Jump, Robin L. P.</creatorcontrib><description>BACKGROUND
Data describing antibiotic use in U.S. nursing homes remain limited. We report antibiotic use among skilled nursing facility residents from 29 U.S. nursing homes and assessed correlations between antibiotics prescribed to residents in skilled care and nursing home characteristics.
DESIGN
Retrospective cohort study.
SETTING
Twenty‐nine U.S. nursing homes in the same healthcare corporation.
PARTICIPANTS
Residents receiving skilled care in 2016.
MEASUREMENTS
We used pharmacy invoice and nursing home census data to calculate the days of antibiotic therapy per 1,000 days of skilled care (1,000 DOSC), the rate of antibiotic starts per 1,000 DOSC, the length of antibiotic therapy, and the average antibiotic spectrum index. We also assessed correlations between antibiotic use and nursing home characteristics.
RESULTS
Antibiotics accounted for an average of 9.6% (±0.6%) of systemic medications prescribed among residents receiving skilled care. On average, 26.8% (±2.9%) of antibiotics were intravenous. Fluoroquinolones were prescribed at the highest rates (19% across all facilities), followed by beta‐lactam/beta‐lactamase inhibitors (11%), first‐ and second‐generation cephalosporins, sulfonamides, and oral tetracyclines (each at 9%). Both the proportion of residents using enrolled in Medicare and number of unique prescribers responsible for systemic prescriptions positively correlated with the rate of antibiotic starts.
CONCLUSIONS
Our study demonstrates that pharmacy invoices represent a useful and preexisting source of data for assessing antibiotic prescriptions among individuals receiving skilled nursing care. The correlation between the number of unique prescribers and antibiotic starts suggests that prescribers are central to efforts to improve antibiotic use in nursing homes.</description><identifier>ISSN: 0002-8614</identifier><identifier>EISSN: 1532-5415</identifier><identifier>DOI: 10.1111/jgs.16856</identifier><identifier>PMID: 33037613</identifier><language>eng</language><publisher>Hoboken, USA: John Wiley & Sons, Inc</publisher><subject>antibiotic stewardship ; Antibiotics ; Cephalosporins ; fluoroquinolone ; Fluoroquinolones ; Intravenous administration ; Nursing care ; Nursing homes ; Pharmacy ; post‐acute and long‐term care ; Sulfonamides ; Tetracyclines</subject><ispartof>Journal of the American Geriatrics Society (JAGS), 2021-02, Vol.69 (2), p.399-406</ispartof><rights>2020 The American Geriatrics Society</rights><rights>2020 The American Geriatrics Society.</rights><rights>2021 American Geriatrics Society and Wiley Periodicals LLC</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3536-1f0788f4b247b24b445fc83e7ea207cf7489779dc7d10fba63f09d5b02c107c73</citedby><cites>FETCH-LOGICAL-c3536-1f0788f4b247b24b445fc83e7ea207cf7489779dc7d10fba63f09d5b02c107c73</cites><orcidid>0000-0001-5601-8996</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fjgs.16856$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fjgs.16856$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33037613$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Song, Sunah</creatorcontrib><creatorcontrib>Wilson, Brigid M.</creatorcontrib><creatorcontrib>Bej, Taissa</creatorcontrib><creatorcontrib>Gravenstein, Stefan</creatorcontrib><creatorcontrib>Carter, Rebecca R.</creatorcontrib><creatorcontrib>Marek, Joseph</creatorcontrib><creatorcontrib>Jump, Robin L. P.</creatorcontrib><title>Antibiotic Use Among Residents Receiving Skilled Nursing Care in 29 U.S. Nursing Homes</title><title>Journal of the American Geriatrics Society (JAGS)</title><addtitle>J Am Geriatr Soc</addtitle><description>BACKGROUND
Data describing antibiotic use in U.S. nursing homes remain limited. We report antibiotic use among skilled nursing facility residents from 29 U.S. nursing homes and assessed correlations between antibiotics prescribed to residents in skilled care and nursing home characteristics.
DESIGN
Retrospective cohort study.
SETTING
Twenty‐nine U.S. nursing homes in the same healthcare corporation.
PARTICIPANTS
Residents receiving skilled care in 2016.
MEASUREMENTS
We used pharmacy invoice and nursing home census data to calculate the days of antibiotic therapy per 1,000 days of skilled care (1,000 DOSC), the rate of antibiotic starts per 1,000 DOSC, the length of antibiotic therapy, and the average antibiotic spectrum index. We also assessed correlations between antibiotic use and nursing home characteristics.
RESULTS
Antibiotics accounted for an average of 9.6% (±0.6%) of systemic medications prescribed among residents receiving skilled care. On average, 26.8% (±2.9%) of antibiotics were intravenous. Fluoroquinolones were prescribed at the highest rates (19% across all facilities), followed by beta‐lactam/beta‐lactamase inhibitors (11%), first‐ and second‐generation cephalosporins, sulfonamides, and oral tetracyclines (each at 9%). Both the proportion of residents using enrolled in Medicare and number of unique prescribers responsible for systemic prescriptions positively correlated with the rate of antibiotic starts.
CONCLUSIONS
Our study demonstrates that pharmacy invoices represent a useful and preexisting source of data for assessing antibiotic prescriptions among individuals receiving skilled nursing care. The correlation between the number of unique prescribers and antibiotic starts suggests that prescribers are central to efforts to improve antibiotic use in nursing homes.</description><subject>antibiotic stewardship</subject><subject>Antibiotics</subject><subject>Cephalosporins</subject><subject>fluoroquinolone</subject><subject>Fluoroquinolones</subject><subject>Intravenous administration</subject><subject>Nursing care</subject><subject>Nursing homes</subject><subject>Pharmacy</subject><subject>post‐acute and long‐term care</subject><subject>Sulfonamides</subject><subject>Tetracyclines</subject><issn>0002-8614</issn><issn>1532-5415</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp1kF9LwzAUxYMobk4f_AJS8EUf2iVN2qSPY-imDAXnfA1tejsy-2cmq7Jvb2bnHgQDN_fm3B-HcBC6JDgg7gxXSxuQWETxEeqTiIZ-xEh0jPoY49AXMWE9dGbtCmMSYiFOUY9STHlMaB-9jeqNznSz0cpbWPBGVVMvvRewOod6Y92kQH9qp83fdVlC7j21xu7e49SAp2svTLxFMA8O-rSpwJ6jkyItLVzs-wAt7u9ex1N_9jx5GI9mvqIRjX1SYC5EwbKQcVcZY1GhBAUOaYi5KjgTCedJrnhOcJGlMS1wkkcZDhVxe04H6KbzXZvmowW7kZW2CsoyraFprQwZS5LY3cSh13_QVdOa2v3OUYLFIonwjrrtKGUaaw0Ucm10lZqtJFjuwpYubPkTtmOv9o5tVkF-IH_TdcCwA750Cdv_neTjZN5ZfgOByIXR</recordid><startdate>202102</startdate><enddate>202102</enddate><creator>Song, Sunah</creator><creator>Wilson, Brigid M.</creator><creator>Bej, Taissa</creator><creator>Gravenstein, Stefan</creator><creator>Carter, Rebecca R.</creator><creator>Marek, Joseph</creator><creator>Jump, Robin L. P.</creator><general>John Wiley & Sons, Inc</general><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7TK</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-5601-8996</orcidid></search><sort><creationdate>202102</creationdate><title>Antibiotic Use Among Residents Receiving Skilled Nursing Care in 29 U.S. Nursing Homes</title><author>Song, Sunah ; Wilson, Brigid M. ; Bej, Taissa ; Gravenstein, Stefan ; Carter, Rebecca R. ; Marek, Joseph ; Jump, Robin L. P.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3536-1f0788f4b247b24b445fc83e7ea207cf7489779dc7d10fba63f09d5b02c107c73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>antibiotic stewardship</topic><topic>Antibiotics</topic><topic>Cephalosporins</topic><topic>fluoroquinolone</topic><topic>Fluoroquinolones</topic><topic>Intravenous administration</topic><topic>Nursing care</topic><topic>Nursing homes</topic><topic>Pharmacy</topic><topic>post‐acute and long‐term care</topic><topic>Sulfonamides</topic><topic>Tetracyclines</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Song, Sunah</creatorcontrib><creatorcontrib>Wilson, Brigid M.</creatorcontrib><creatorcontrib>Bej, Taissa</creatorcontrib><creatorcontrib>Gravenstein, Stefan</creatorcontrib><creatorcontrib>Carter, Rebecca R.</creatorcontrib><creatorcontrib>Marek, Joseph</creatorcontrib><creatorcontrib>Jump, Robin L. P.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of the American Geriatrics Society (JAGS)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Song, Sunah</au><au>Wilson, Brigid M.</au><au>Bej, Taissa</au><au>Gravenstein, Stefan</au><au>Carter, Rebecca R.</au><au>Marek, Joseph</au><au>Jump, Robin L. P.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Antibiotic Use Among Residents Receiving Skilled Nursing Care in 29 U.S. Nursing Homes</atitle><jtitle>Journal of the American Geriatrics Society (JAGS)</jtitle><addtitle>J Am Geriatr Soc</addtitle><date>2021-02</date><risdate>2021</risdate><volume>69</volume><issue>2</issue><spage>399</spage><epage>406</epage><pages>399-406</pages><issn>0002-8614</issn><eissn>1532-5415</eissn><abstract>BACKGROUND
Data describing antibiotic use in U.S. nursing homes remain limited. We report antibiotic use among skilled nursing facility residents from 29 U.S. nursing homes and assessed correlations between antibiotics prescribed to residents in skilled care and nursing home characteristics.
DESIGN
Retrospective cohort study.
SETTING
Twenty‐nine U.S. nursing homes in the same healthcare corporation.
PARTICIPANTS
Residents receiving skilled care in 2016.
MEASUREMENTS
We used pharmacy invoice and nursing home census data to calculate the days of antibiotic therapy per 1,000 days of skilled care (1,000 DOSC), the rate of antibiotic starts per 1,000 DOSC, the length of antibiotic therapy, and the average antibiotic spectrum index. We also assessed correlations between antibiotic use and nursing home characteristics.
RESULTS
Antibiotics accounted for an average of 9.6% (±0.6%) of systemic medications prescribed among residents receiving skilled care. On average, 26.8% (±2.9%) of antibiotics were intravenous. Fluoroquinolones were prescribed at the highest rates (19% across all facilities), followed by beta‐lactam/beta‐lactamase inhibitors (11%), first‐ and second‐generation cephalosporins, sulfonamides, and oral tetracyclines (each at 9%). Both the proportion of residents using enrolled in Medicare and number of unique prescribers responsible for systemic prescriptions positively correlated with the rate of antibiotic starts.
CONCLUSIONS
Our study demonstrates that pharmacy invoices represent a useful and preexisting source of data for assessing antibiotic prescriptions among individuals receiving skilled nursing care. The correlation between the number of unique prescribers and antibiotic starts suggests that prescribers are central to efforts to improve antibiotic use in nursing homes.</abstract><cop>Hoboken, USA</cop><pub>John Wiley & Sons, Inc</pub><pmid>33037613</pmid><doi>10.1111/jgs.16856</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0001-5601-8996</orcidid></addata></record> |
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| ispartof | Journal of the American Geriatrics Society (JAGS), 2021-02, Vol.69 (2), p.399-406 |
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| language | eng |
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| source | Access via Wiley Online Library |
| subjects | antibiotic stewardship Antibiotics Cephalosporins fluoroquinolone Fluoroquinolones Intravenous administration Nursing care Nursing homes Pharmacy post‐acute and long‐term care Sulfonamides Tetracyclines |
| title | Antibiotic Use Among Residents Receiving Skilled Nursing Care in 29 U.S. Nursing Homes |
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