ArticleBMC health services research2020
Trends, determinants and differences in antibiotic use in 68 residential aged care homes in Australia, 2014-2017: a longitudinal analysis of electronic health record data.
Article in BMC health services research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 2 of them syntheses that pooled it.
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Who cites it
12 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Resident-, prescriber-, and facility-level factors associated with antibiotic use in long-term care facilities: a systematic review of quantitative studies.Antimicrobial resistance and infection control · 2024Pooled it
- Pooled it
- Trends in microbiology testing in Australian long-term care facilities: national cohort study.BMC infectious diseases · 2026Article
- Relationship between medication safety-related processes and medication use in residential aged care facilities.Australasian journal on ageing · 2024Article
- Analysis of longitudinal patterns and predictors of medicine use in residential aged care using group-based trajectory modelling: The MEDTRAC-Polypharmacy longitudinal cohort study.British journal of clinical pharmacology · 2024Article
- Use of antibiotics for urinary tract infections up to and after care home admission in Denmark: a nationwide study.European geriatric medicine · 2024Article
- Real-World Data about Commonly Used Antibiotics in Long-Term Care Homes in Australia from 2016 to 2019.Antibiotics (Basel, Switzerland) · 2023Article
- Prophylactic Antimicrobial Prescribing in Australian Residential Aged-Care Facilities: Improvement is Required.Drugs - real world outcomes · 2022Article
- Article
- Measuring quality of gout management in residential aged care facilities.Rheumatology advances in practice · 2022Article
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Authors and funding
6 authors.
Funding
Abstract
backgroundInternationally, point prevalence surveys are the main source of antibiotic use data in residential aged care (RAC). Our objective was to describe temporal trends in antibiotic use and antibiotics flagged for restricted use, resident characteristics associated with use, and variation in use by RAC home, using electronic health record data.
methodsWe conducted a retrospective cohort study of 9793 unique residents aged ≥65 years in 68 RAC homes between September 2014 and September 2017, using electronic health records. We modelled the primary outcome of days of antibiotic therapy /1000 resident days (DOT/1000 days), and secondary outcomes of number of courses/1000 days and the annual prevalence of antibiotic use. Antibiotic use was examined for all antibiotics and antibiotics on the World Health Organization's (WHO) Watch List (i.e. antibiotics flagged for restricted use).
resultsIn 2017, there were 85 DOT/1000 days (99% CI: 79, 92), 8.0 courses/1000 days (99% CI: 7.6, 8.5), and 63.4% (99% CI: 61.9, 65.0) of residents received at least one course of antibiotics. There were 7.7 DOT/1000 days (99% CI: 6.69, 8.77) of antibiotics on the WHO Watch List administered in 2017. Antibiotic use increased annually by 4.09 DOT/1000 days (99% CI: 1.18, 6.99) before adjusting for resident factors, and 3.12 DOT/1000 days (99% CI: - 0.05, 6.29) after adjustment. Annual prevalence of antibiotic use decreased from 68.4% (99% CI: 66.9, 69.9) in 2015 to 63.4% (99% CI: 61.9, 65.0) in 2017, suggesting fewer residents were on antibiotics, but using them for longer. Resident factors associated with higher use were increasing age; chronic respiratory disease; a history of urinary tract infections, and skin and soft tissue infections; but dementia was associated with lower use. RAC home level antibiotic use ranged between 44.0 to 169.2 DOT/1000 days in 2016. Adjusting for resident factors marginally reduced this range (42.6 to 155.5 DOT/1000 days).
conclusionsAntibiotic course length and RAC homes with high use should be a focus of antimicrobial stewardship interventions. Practices in RAC homes with low use could inform interventions and warrant further investigation. This study provides a model for using electronic health records as a data source for antibiotic use surveillance in RAC.
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