Antimicrobial stewardship in long term care facilities involves setting commitments and actions to optimize antibiotic therapy while minimizing the emergence of antibiotic resistance and other adverse effects.
Studies have shown that 40-75% of the antibiotic courses prescribed in long term care facilities are unnecessary or inappropriate, leading to significant risks from antibiotic overuse. Any actions taken to improve antibiotic use promotes better outcomes for residents in long term care settings.
An antimicrobial stewardship program (ASP) is an effective strategy for limiting the excessive use of antibiotics. Establishing an ASP requires the implementation of infection prevention and control guidelines, education and awareness of antimicrobial use regulations and collection of surveillance data to provide feedback.
NCCID links to materials produced by various organizations to promote antimicrobial stewardship in long term care facilities. These materials include steps for implementing antimicrobial stewardship programs and evidence based guidelines for clinical assessments and treatment.
AMS Programs in LTC facilities
The following links have useful information on implementing and sustaining antimicrobial stewardship programs in long term care facilities:
- CDC: The Core Elements of Antibiotic Stewardship for Nursing Homes and Assisted Living (LTCF)
- Public Health Ontario: Antimicrobial Stewardship Strategies
- Saskatoon Health Region: Antimicrobial Stewardship Program
- Agency for Healthcare Research and Quality: Nursing Home Antimicrobial Stewardship Guide
- Minnesota Department of Health: Minnesota Antimicrobial Stewardship Program Tool Kit for Long Term Care Facilities
- Antimicrobialstewardship.com: The Sinai Health System – University Health Network Antimicrobial Stewardship program
Diagnosis & Treatment Guidelines
The following resources offer useful information on diagnosis and treatment guidelines:
- Do Bugs Need Drugs: Clinical assessment and management of urinary tract infections and nursing home acquired pneumonia
- AMMI Canada: Resources to stop inappropriate antibiotic use for asymptomatic bacteriuria in LTC residents
- Towards Optimized Practice (TOP) Alberta: Diagnosis and management of urinary tract infection in LTCFs
- Public Health Ontario: Urinary Tract Infection Program
- Saskatoon Health Region: Antimicrobial Stewardship Program – Treatment Strategies
- Minnesota Department of Health: Minnesota Antimicrobial Stewardship Program – Clinical decision-making tools