New recommendations from the Centers for Disease Control and Prevention (CDC) advise all nursing homes to improve antibiotic prescribing practices and reduce their inappropriate use to protect residents from the consequences of antibiotic-resistant infections, such as C. difficile.
To guide these improvements, CDC has released a new resource: Core Elements of Antibiotic Stewardship for Nursing Homes. The Core Elements for Nursing Homes expand upon CDC’s recommendation last year that all acute care hospitals implement an antibiotic stewardship program designed to optimize treatment of infections while reducing adverse events associated with antibiotic use.
Protecting nursing home residents
The Core Elements provide practical ways for nursing homes to initiate or expand antibiotic stewardship activities. The guide provides examples of how antibiotic use can be monitored and improved by nursing home leadership and staff. The companion checklist can be used to assess policies and practices already in place and to review progress in expanding stewardship activities on a regular basis. However, depending on resources, some facilities may need more time to implement all these important protections. Ultimately, nursing home antibiotic stewardship activities should, at a minimum, include the following:
Leadership commitment: Demonstrate support and commitment to safe and appropriate antibiotic use.
Accountability: Identify leaders who are responsible for promoting and overseeing antibiotic stewardship activities at the nursing home.
Drug expertise: Establish access to experts with experience or training in improving antibiotic use.
Action: Take at least one new action to improve the way antibiotics are used in the facility.
Tracking: Measure how antibiotics are used and the complications (e.g., C. difficile infections) from antibiotics in the facility.
Reporting: Share information with healthcare providers and staff about how antibiotics are used in the facility.
Education: Provide resources to healthcare providers, nursing staff, residents and families to learn about antibiotic resistance and opportunities for improving antibiotic use.
As part of the plan, within three years CDC will provide technical assistance to federal facilities (e.g., those operated by the Department of Defense, the Department of Veterans Affairs, and the Indian Health Service) and other large health systems to scale up implementation and assess interventions to improve outpatient antibiotic prescribing, extend effective interventions to long-term care settings, and ensure long-term sustainability of antibiotic stewardship efforts.