Antibiotic stewardship in French nursing homes: a 2019 regional survey.
JAC Antimicrob Resist 2021;
3:dlab105. [PMID:
34647021 PMCID:
PMC8499689 DOI:
10.1093/jacamr/dlab105]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 06/28/2021] [Indexed: 11/18/2022] Open
Abstract
Background
Antibiotic resistance is a growing issue in nursing homes (NHs). Antibiotic
stewardship (ABS) programmes can reduce antibiotic use in NHs, but few
studies have assessed to what extent they are implemented in NHs.
Objectives
To describe ABS current practices and describe the opinion of NH stakeholders
regarding ABS and opportunities for improvement in one French region.
Methods
We invited by e-mail the medical and nurse coordinators of all NHs of the
Grand Est region, France, to participate in our survey in 2019. The online
questionnaire included 35 questions covering four topics: NH
characteristics, current ABS practices, attitudes towards ABS and opinions
on strategies to promote ABS. A score evaluating implementation of core ABS
elements was calculated using the current ABS practice responses.
Results
Out of 417 NHs, 75 (18%) participated in our survey. The three most
implemented ABS activities were antibiotic consumption monitoring
(65%), antibiotic plan documentation (56%) and antibiotic
prescription guide distribution (54%). Audit and feedback, training
sessions or identification of a local ABS leader ranged from 13% to
29%. Participants positively perceived ABS and most suggestions to
improve ABS programmes in NH, with maximal interest in training, audit and
feedback interventions. The median score for implementation of core ABS
elements was 3.3 (IQR = 2.3–5.4; theoretical
range 0–11), and the score distribution was not associated with any
NH characteristic.
Conclusions
While there is still room for improvement, NHs had a positive attitude
towards ABS strategies. Some regional and national initiatives to promote
ABS in NHs exist and should be actively promoted.
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