Antibiotic Stewardship in Nursing Homes: How You Can Prevent Antibiotic Resistance

Antibiotic Stewardship in Nursing Homes: How You Can Prevent Antibiotic Resistance


More than 2 million people in the United States
become sick from antibiotic-resistant bacteria each year. Resistance occurs when bacteria in your body
change making antibiotics that were once used to
fight the bacteria no longer effective. This can happen when you are given antibiotics
you may not need, making bacteria strong enough to change 00:26.800 –>00:29.509 and resist the antibiotic. 00:29.509 –>00:31.230 Of those who get sick 20,000 do not survive. And those who do survive may require longer treatment time, 00:37.280 –>00:39.160 have higher health care costs, spend more time in the hospital, and develop more complications. Antibiotic Stewardship Programs can help. These programs help ensure people get the
right antibiotic, the right dose at the right time and for the right length of time. So how did antibiotic resistance become a
problem? When used properly, antibiotics save lives and help your body fight infections by killing bacteria. However, some bacteria escape the medication and become resistant to the antibiotics. These bacteria increase and can cause the
person to get sick again. When this happens, different antibiotics are
needed to kill the bacteria. Increasing the chance of even more bacteria becoming resistant making you sick longer, requiring additional medication and costing more money. Additional antibiotics could also lead to
serious side effects. This brings us to nursing homes Antibiotics are among the most commonly prescribed drugs in nursing homes. On any given day more than 10% of residents are taking an antibiotic. In addition, residents living together in
a group setting especially those who travel between the nursing
home and hospital or dialysis centers, run the risk of transferring bacteria to other residents. Because of these reasons, experts have seen a high rate of antibiotic resistance in many nursing homes. But what can be done? Besides practicing safe hygiene like hand
washing, we must promote the use of antibiotics only when they can help and only
when the antibiotics are necessary. We must remember, the more we use antibiotics, the more likely resistant bacteria will develop
and spread. Mrs. Parker is a 74-year-old nursing home
resident with dementia who started taking antibiotics for a urinary
tract infection or UTI. During her treatment, she developed bloody
diarrhea along with abdominal cramps and a low-grade
fever. She tested positive for Clostridium difficile
toxin or “C. diff”. This infection developed because the antibiotics
killed much of her normal bacteria leaving space for more dangerous bacteria
to take over. Her C. diff infection was a side effect of
taking antibiotics and could have been severe or life-threatening if untreated. People living in nursing homes are frequently prescribed antibiotics
for urinary tract infections. However, many UTIs are misdiagnosed. If a urine culture shows bacteria, a common practice has been to give an antibiotic. However, we now know that in older people, sometimes bacteria can be in the bladder 03:23.010 –>03:25.680 without causing an infection or harm. For that reason, a positive urine culture
in a person without any symptoms should not be treated with an antibiotic. Before giving an antibiotic, assess the resident for
infectious signs or symptoms. If none are present, take steps to monitor the resident and make sure they are feeling well and do not develop new symptoms. This is new information for many people yet now considered a standard of care. What can you do to help stop antibiotic resistant
bacteria in the nursing home? If you are a resident or family member, you
should: Talk with your medical team about
the benefits and harms of antibiotics. Do not request an antibiotic when your
doctor says it is not needed, and do not take an antibiotic for
a virus such as a cold or the flu. If you or your family member
are prescribed antibiotics, find out why the antibiotic was
prescribed. You could ask: 04:22.040 –>04:24.366 Are antibiotics necessary? Are there any alternatives? Can we hold off on the antibiotics for a couple
days and closely monitor the symptoms? When should the antibiotic be discontinued? If you and your provider decide you could
benefit from an antibiotic, take it as prescribed for as long
as ordered and ask: How should the antibiotic be taken? How much antibiotic is neede What side effects should
I look for and report? Finally, if you are a staff
member in a nursing home, encourage residents and family
members to ask questions so they will understand whether
or not an antibiotic is needed. Antibiotics are certainly necessary and
important in certain situations. But you can help yourself and others by encouraging the use of antibiotics
only when they are needed. We cannot stop antibiotic resistance, but we can slow it down. Remember, don’t take
antibiotics just in case. Take them only when needed.

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