Prevalence of Antimicrobial Prescribing in Long-Term Care Facilities in a Local Health Authority of Northern Italy

Int J Environ Res Public Health. 2022 Oct 17;19(20):13412. doi: 10.3390/ijerph192013412.

Abstract

Background: Almost half of antimicrobial prescriptions in long-term care facilities (LTCFs) is inappropriate. This broad use might represent a strong contributor to antimicrobial resistance in these facilities. This study aimed to assess antibiotic use patterns and potential associated factors with a survey of LTCFs in the local health authority (LHA) of Novara.

Methods: A cross-sectional study was conducted in 25 LTCFs in the LHA of Novara following the healthcare-associated infection in LCTFs (HALT) protocol. Information on residents and facilities was assessed. Antibiotic usage and potential determinants were also estimated.

Results: In total, 1137 patients were screened for antibiotic usage. Mean age was 84.58 years (SD 9.77), and the majority were female (76.52%). Twenty-six were antibiotic users (prevalence rate 2.29%, 95%CI 1.50-3.33). Antimicrobials were mainly prescribed orally (84.62%). Potential risk factors for antibiotic prescription were catheter use (central and peripheral venous, p-values 0.0475 and 0.0034, respectively, and urinary, p-value 0.0008), immobilization (p-value < 0.0001), and sex (p-value 0.0486).

Conclusions: This study identified a low prevalence of antimicrobic consumption in LTCFs. Further surveillance studies are warranted to identify trends and changes in pathogen incidence and antimicrobial resistance and to inform public health authorities on the necessity of prudent use of antimicrobials in LCTFs.

Keywords: antibiotic consumption; antibiotics; antimicrobial stewardship; long-term facilities.

MeSH terms

  • Aged, 80 and over
  • Anti-Bacterial Agents / therapeutic use
  • Anti-Infective Agents* / therapeutic use
  • Cross-Sectional Studies
  • Drug Utilization*
  • Female
  • Humans
  • Inappropriate Prescribing
  • Italy / epidemiology
  • Long-Term Care
  • Male
  • Prevalence

Substances

  • Anti-Infective Agents
  • Anti-Bacterial Agents

Grants and funding

The research project was conducted under the supervision of L.S. and M.P. This study was carried out as part of the author’s routine work. No funding was received for the writing of this paper.