This article is more than 5 years old. Information may no longer be current.
Antibiotics overprescribed among home-care patients in Canada
Mertz D. Infect Control Hosp Epidemiol. 2011;32:710-713.
Antibiotics may be overused among home-care patients in Canada, particularly those aged younger than 65 years.
“Antibiotics are frequently used in this population, particularly among those with more complicated medical conditions; prudent use of antibiotics is warranted for this population,” Mark Loeb, MD,of the department of pathology and molecular medicine and clinical epidemiology and biostatistics at McMaster University in Ontario, Canada, told Infectious Disease News.
Loeb and colleagues conducted a cross-sectional study to assess antibiotic use among elderly patients receiving home-care services in Ontario, Canada. Data were pooled from Resident Assessment Instrument–Home Care (RAI-HC) among 126,339 patients receiving home care for more than 60 days during 2004. Home care included a nurse assessment and collection of data based on assessor observations, patient and family self-report, and other medical records.
All antibiotics used within 7 days before the assessment period were recorded. Researchers selected 32 variables from the RAI-HC database as potential factors influencing antibiotic use:
- Cognitive performance scale (range 0-6).
- Depression rating scale (range 0-14).
- Instrumental activities of daily living scale (range 0-6).
- Activities of daily living scale (ADL; range 0-16).
- Scale of changes in health, end-stage disease and signs of symptoms (CHESS; range 0-5).
- Pain scale (range 0-3).
Results indicated that 5.4% of home-care patients received antibiotic treatment, of which 26% were fluoroquinolones. In addition, antibiotic treatment was most frequent in patients aged younger than 65 years and among those with a poorer health status.
Compared with a mean age of 77 years for patients that reported no antibiotic treatment, the mean age of patients receiving antibiotics was 73 years (P<.001).
“Overuse of antibiotics may be most prevalent in these subgroups of patients,” the researchers wrote. “Therefore, we would suggest focusing on this group of patients to assess the appropriateness of antibiotic prescription and to implement intervention, if indicated, to optimize antibiotic use.”
The researchers recommend continued monitoring of antibiotic use in home-care patients, more effective methods of diagnosis that allow appropriate antibiotic use, and further research on the indications and outcomes of antibiotic treatment.
“Our results reveal tremendous variability in how and why antibiotics are prescribed, and that overuse in the home-care population is likely,” Loeb said in a press release. “Younger and sicker patients seem to be at added risk for misuse and should be the focus of further study to assess the appropriateness of antibiotic use at home.”
Disclosure: Dr. Loeb reports no relevant financial disclosures.
 |
Follow InfectiousDiseaseNews.com on Twitter. |