Data covered the period between 2013 and 2017. Among more than 1.5 million nursing home residents, 66.2% were prescribed at least one antibiotic. During the study period, the number of dispensed antibiotics per resident was two, and residents received 10 days of therapy, Andrew R Zullo, PharmD, PhD, of Brown University, and colleagues reported in the Journal of Infectious Diseases.

Prevalent prescriptions

The most prevalent antibiotic prescriptions were levofloxacin, ciprofloxacin and sulfamethoxazole-trimethoprim. The most prevalent antibiotics classes included fluoroquinolones, sulfonamides, and related agents, and first-generation cephalosporins, which nursing home clinicians often used to treat urinary tract infections and pneumonia. 

The type of antibiotics differed based on prescribing prevalence and rate of antibiotic days-of-therapy. For example, nitrofurantoin was the sixth most prevalent antibiotic prescribed but had the highest days of therapy, Zullo and colleagues noted. Prescribing multiple courses or longer courses of antibiotics during a resident’s stay increased the rate of days of therapy, but not prescribing prevalence, they reported.

Results of the current nursing home study may be helpful for use in antibiotic stewardship interventions, allowing nursing home clinicians to improve prescribing appropriateness, and reduce related adverse outcomes in these settings, Zullo and colleagues concluded.