Antibiotic consumption in 30 French nursing homes: a point prevalence study from the European Surveillance of Antimicrobial Consumption nursing home subproject

Abstract number: P1336

Gavazzi G., GIbert P., Fontaine L., Stroobants R., Hendrickx E., Muller A., Vankerckhoven V., Goossens H., Jans B.

Objectives: Elderly individuals and particularly elderly living in Nursing home (NH) exhibit specific features for infections including diagnostic difficulties, increased multidrug resistant bacteria and high antibiotic (AB) use. Optimizing the use of ABs in the nursing home population is therefore an important priority of quality of care. However, considering AB consumption, no data are available in Europe. The objectives of the European Surveillance of Antimicrobial Consumption Nursing Home (ESAC-NH) subproject are to study AB use and prescriptions among European residents living in high skilled NH. The results presented here are from the 30 French Nursing homes participating to the ESAC-NH sub-project.

Methods: In accordance with the methodology of the ESAC-NH subproject, a first point prevalence survey (PPS) was carried out in 30 NH in France within a one-month-period (one day in April 2009). Inclusion criteria for residents were to be resident in the NH (>24 hours) and to receive systemic AB(s) at the time of the PPS. Data were obtained from nursing notes, medication administration records and staff related to antimicrobial prescribing, facility and resident characteristics (e.g. prevalence of urinary and vascular catheter, wound, disorientation, bedridden). Indication, type and dosage for AB and, microorganisms were reported. Data were entered into customised web-based software and analysed descriptively.

Results: ABs were administered to 112 (4.8%) of 2318 eligible elderly residents. Characteristics of the residents were as follows: presence of urinary catheter (1.4%), vascular catheter (<0.01%), urinary incontinence (56.1%), disorientation (55.9%), wound (13.6%), bedridden (35.4%). Respiratory (RTI) and Urinary tract infections (UTI) were the most frequent infections (60.3% and 25.8%, respectively). Microbial identification was only present in 1.5% of RTI, and in 65.5% of UTI. The most frequent ABs were b-lactams for RTI (>70%, oral route 82%); quinolones(34.5%), cotrimoxazole (20.7%), and nitrofuranes (10.4%) were the most frequent ABs for UTI (intravenous route <10%).

Conclusion: Surprisingly in France, antibiotic use in the NH population was moderate. Although the PPS was organised during the Spring, which may explain the low rate of antibiotic use, the low prevalence of urinary catheter may have decreased the rate of AB use for UTI. This study indicates also that, to optimize antibiotic use in NH, guidelines should mainly focus on UTI and RTI.

Session Details

Date: 10/04/2010
Time: 00:00-00:00
Session name: Abstracts 20th European Congress of Clinical Microbiology and Infectious Diseases
Location: Vienna, Austria, 10 - 13 April 2010
Presentation type:
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