Abstract
Antimicrobials are commonly prescribed and contribute to the development of antimicrobial resistance in long-term care facilities (LTCFs). In 2010, the European Centre for Disease Prevention and Control initiated point prevalence surveys (PPS) of healthcare-associated infections and antimicrobial use in European LTCFs, performed by external contractors as the Healthcare-Associated infections in Long-Term care facilities (HALT) projects. Here, we investigated prevalence and characteristics of antimicrobial use and antimicrobial stewardship indicators in European LTCFs in 2016–17. Twenty-four European Union/European Economic Area (EU/EEA) countries, the former Yugoslav Republic of Macedonia and Serbia participated in the third PPS in European LTCFs. Overall, 4.9% (95% confidence interval: 4.8–5.1) of LTCF residents in the EU/EEA participating countries received at least one antimicrobial. The most commonly reported Anatomical Therapeutic Chemical (ATC) groups were beta-lactam antibacterials/penicillins (J01C), other antibacterials (J01X) (e.g. glycopeptide antibacterials, polymyxins), quinolones (J01M), sulfonamides and trimethoprim (J01E), and other beta-lactams (J01D). Urinary tract infections and respiratory tract infections were the main indications for antimicrobial prescription. This PPS provides updated and detailed information on antimicrobial use in LTCFs across the EU/EEA that can be used to identify targets for future interventions, follow-up of these interventions and promote prudent use of antimicrobials in European LTCFs.
Highlights
Life expectancy is increasing steadily in the European Union/European Economic Area (EU/EEA)
Long-term care facilities (LTCFs) deliver a blend of health and social services to people who are limited in their ability to live independently, especially due to old age, and are in need of less intensive medical care than that usually provided in hospitals [3]
We investigated the prevalence and characteristics of antimicrobial use and antimicrobial stewardship indicators in European long-term care facilities (LTCFs) reported in the third European point prevalence surveys (PPS) of healthcare-associated infections (HAIs) and antimicrobial use in LTCFs (HALT-3) in 2016–17
Summary
Life expectancy is increasing steadily in the European Union/European Economic Area (EU/EEA). The ageing population is one reason for the transitions in healthcare delivery systems taking place in several EU/EEA countries This includes reductions in hospital beds and in several countries more patient care being provided in long-term care settings [2]. Despite the fact that less intensive medical care is provided in LTCFs than in hospitals, healthcare-associated infections (HAIs) are common in the vulnerable LTCF populations [4,5,6,7,8,9] For this reason, antimicrobials are commonly prescribed in LTCFs, contributing to the development of antimicrobial resistance (AMR) and possibly leading to adverse events such as Clostridium difficile infection, and infections that are more difficult to treat [10,11]. The lack of diagnostic capabilities may lead to suboptimal antimicrobial prescription in LTCFs [14,15]
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