Nursing Home Antibiotic Stewardship Policy and Antibiotics Use: 2013-2017.
Mansi Agarwal, Leah V Estrada, Tadeja Gracner and 2 others
PMID 34297980WHAT IT FOUND
Nursing homes with stronger antibiotic stewardship policies saw reduced antibiotic use.
The decrease was most significant in facilities implementing four or five specific policies, suggesting that comprehensive programs effectively lower unnecessary prescriptions.
Key findings
01Antibiotic stewardship policy intensity increased drastically between 2013 and 2017, with the percentage of nursing homes having no policies dropping from 20% to 1%.
02Overall antibiotic use prevalence decreased from 2013 to 2017, and 45% of this decrease was attributable to improved policy intensity.
03Significant reductions in antibiotic use were observed only in nursing homes with high policy intensity (four or five policies), particularly for residents with Alzheimer's disease or UTIs.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study used MDS data which has not been validated for measuring antibiotic prevalence and may underestimate actual use. The design is observational and cannot prove causation; other concurrent changes may have influenced antibiotic use. The 2017 survey was conducted shortly before the CMS deadline for stewardship programs, potentially underestimating the full impact of these policies. Self-selection bias is possible, as participating nursing homes may have already had stronger stewardship programs.
Declared interests
The research was supported by the National Institute on Aging (N.I.H., Extramural). No other conflicts of interest are explicitly detailed in the provided text.
The easy way to misread this
Do not assume that implementing any number of stewardship policies will reduce antibiotic use. The data showed significant reductions only in facilities with four or five policies; facilities with fewer than four policies did not see a statistically significant decrease in antibiotic use.