High Nursing-Home Antibiotic Use Is Associated with Elevated Risk for Antibiotic-Related Adverse Outcomes

Excessive antibiotic use in nursing homes is a problem that seems to defy solution. In this longitudinal cohort study, investigators examined adverse effects associated with high antibiotic use in nearly 111,000 older adults in 607 nursing facilities in Ontario, Canada. Nursing homes were classified in tertiles, corresponding to proportions of resident-days in which antibiotics were used. The most commonly prescribed antibiotics were penicillins (33%) and fluoroquinolones (29%).

During the 2-year study, antibiotic use ranged from 20 to 198 use-days per 1000 resident-days. In adjusted analyses, antibiotic-related adverse events (i.e., Clostridium difficile infections, diarrhea or gastroenteritis, development of antibiotic-resistant infections…