Abstract
Residents in long-term care are at high risk of infections because of their old age and many related health problems that lead to frequent antibiotic prescribing. The aim of the study was to assess antibiotic use in Slovenian long-term care facilities (LTCFs). The point-prevalence study was conducted between April and June 2016. Online questionnaires were sent to all Slovenian LTCFs. Eighty (68.4%) of the 117 LTCFs contacted, caring for 13,032 residents (70.6% of all Slovenian LTCF residents), responded to the survey. On the day of the study, the mean antibiotic prevalence per LTCF was 2.4% (95% confidence interval: 1.94–2.66). Most (70.2%) of the residents taking antibiotics were female. Most residents were being treated for respiratory tract (42.7%) or urinary tract (33.3%) infections. Co-amoxiclav and fluoroquinolones were the most frequently prescribed antibiotics (41.0% and 22.3% respectively). Microbiological tests were performed for 5.2% of residents receiving antibiotics. Forty nine (19.8%) residents receiving antibiotics were colonised with multidrug-resistant bacteria (MDR). Antibiotic use in Slovenian LTCFs is not very high, but most prescribed antibiotics are broad-spectrum. Together with low use of microbiological testing and high prevalence of colonisation with MDR bacteria the situation is worrisome and warrants the introduction of antimicrobial stewardship interventions.
Highlights
All European Union countries have seen an increase in the population aged 65 years and over in the past 10 years
The antibiotic treatment for 208 of 247 residents (84.2%) was prescribed by general practitioners working in the long-term care facilities (LTCFs); for 17 cases (6.9%) the treatment was started in hospital, for 11 cases (4.5%) the antibiotics were prescribed in specialist clinics, and four antibiotic therapies (1.6%) were prescribed by a doctor on duty
Several other studies have investigated the prevalence of antibiotic use in LTCFs with similar methodology
Summary
All European Union countries have seen an increase in the population aged 65 years and over in the past 10 years. In many countries, including Slovenia, elderly people represent one fifth or more of the population [1]. In Organisation for Economic Co-operation and Development member countries in 2011, the number of long-term care beds ranged from 17.5 to 81.7 per 1,000 inhabitants 65 years and older [2]. Residents in longterm care are at high risk of infections because of their old age and age-related health problems that lead to frequent antibiotic prescribing. A systematic literature review showed that 47% to 79% of long-term care facility (LTCF) residents receive antibiotics each year [3]. LTCFs may represent foci for multidrug-resistant bacteria [4]
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