Antibiotic prescribing in UK care homes 2016–2017: retrospective cohort study of linked data

BMC Health Services Research

on behalf of the Preserving Antibiotics through Safe Stewardship group¹  Susan Michie²  Elise Crayton²  Fabiana Lorencatto²  Haydn Williams³  Andrew C. Hayward⁴  Catherine M. Smith⁵  Arnoupe Jhass⁵  Selina Patel⁵  Laura J. Shallcross⁵ 

[1] ;Centre for Behaviour Change, University College London;Four Seasons Health Care;Institute of Epidemiology and Health Care, University College London;Institute of Health Informatics, University College London;

关键词: Anti-bacterial agents;    Long-term care;    Antibiotic stewardship;    Antibiotic prescribing;    care home;    Older people;   

DOI  :  10.1186/s12913-020-05422-z

来源: DOAJ

【 摘 要 】

Abstract Background Older people living in care homes are particularly susceptible to infections and antibiotics are therefore used frequently for this population. However, there is limited information on antibiotic prescribing in this setting. This study aimed to investigate the frequency, patterns and risk factors for antibiotic prescribing in a large chain of UK care homes. Methods Retrospective cohort study of administrative data from a large chain of UK care homes (resident and care home-level) linked to individual-level pharmacy data. Residents aged 65 years or older between 1 January 2016 and 31 December 2017 were included. Antibiotics were classified by type and as new or repeated prescriptions. Rates of antibiotic prescribing were calculated and modelled using multilevel negative binomial regression. Results 13,487 residents of 135 homes were included. The median age was 85; 63% residents were female. 28,689 antibiotic prescriptions were dispensed, the majority were penicillins (11,327, 39%), sulfonamides and trimethoprim (5818, 20%), or other antibacterials (4665, 16%). 8433 (30%) were repeat prescriptions. The crude rate of antibiotic prescriptions was 2.68 per resident year (95% confidence interval (CI) 2.64–2.71). Increased antibiotic prescribing was associated with residents requiring more medical assistance (adjusted incidence rate ratio for nursing opposed to residential care 1.21, 95% CI 1.13–1.30). Prescribing rates varied widely by care home but there were no significant associations with the care home-level characteristics available in routine data. Conclusions Rates of antibiotic prescribing in care homes are high and there is substantial variation between homes. Further research is needed to understand the drivers of this variation to enable development of effective stewardship approaches that target the influences of prescribing.

【 授权许可】

Unknown