Many seniors in long-term care are given antibiotics for longer than likely needed, a new Canadian study suggests.
Most long-term care residents with common bacterial infections such as lower respiratory tract or skin infections can be treated with antibiotics for seven days or less, according to randomized control trial findings.
"High rates of institutional antibiotic use are driving increased rates of antibiotic resistance, Clostridium difficile infection, antibiotic-related adverse events and healthcare costs; yet up to half of antibiotic use in acute and long-term care institutions is unnecessary or inappropriate," Dr. Nick Daneman of the Institute for Clinical Evaluative Sciences in Toronto and his co-authors said in Monday's online issue of JAMA Internal Medicine, previously known as the Journal of the American Medical Association.
Daneman and his team investigated antibiotic use among 66,901 people aged 66 and older living at long-term care facilities in Ontario. They found nearly 78 per cent or 50,061 patients received a course of antibiotics in 2010.
The antibiotics were most commonly prescribed for seven days. But nearly 45 per cent of the treatments, 21,136 courses, exceeded a week, the researchers found.
Some doctors repeatedly prescribed the medication for longer periods.
If all doctors followed the prescribing practices of their peers with the shortest courses of antibiotics, the researchers estimated the number of days antibiotics are used in long-term care would drop by 19 per cent.
"Shortening that tail end of treatment, at which point antibiotics are putting people at potential risk without any potential benefit, seems to be a real feasible way to reduce antibiotic overuse," said Daneman, an adjunct scientist at the institute and an infectious disease specialist.
The researchers also suggested using standardized order sheets and auditing doctors with feedback as hospitals do to reduce unnecessary use of antibiotics.
Investigators concluded that the length of prescriptions weren't always linked to the severity of the illness such as those rarer infections needing longer treatments.
The study was funded by the Canadian Institutes of Health Research.