Abstract
Due to growing concern that unnecessary overuse of antibiotics in nursing homes (NHs) fosters the emergence and dissemination of antibiotic-resistant bacteria, U.S. NHs are being encouraged to establish antibiotic stewardship programs. Unfortunately, successful implementation of such programs is not straightforward, because decision-making involves a complex interplay of factors. Having demonstrated in a clinical trial that antibiotic prescribing can be reduced by over 25% through comprehensive antibiotic stewardship efforts, our research team implemented a dissemination research study in 28 typical community-based NHs to determine change in prescribing and the factors most critical to success in antibiotic stewardship. After one year of implementation, antibiotic prescribing decreased from 12.39 to 10.95 prescriptions/resident day, with most decrease evident for presumed urinary and respiratory tract infections. The session will also discuss the role of nursing home administration, medical staff leadership, staff and provider attitudes, and intervention activities in achieving and maintaining changes in antibiotic prescribing.
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