ArticleAntimicrobial stewardship & healthcare epidemiology : ASHE2021
Description of antibiotic use variability among US nursing homes using electronic health record data.
Article in Antimicrobial stewardship & healthcare epidemiology : ASHE, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
What it found
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Who cites it
6 citing papers in PubMed.
- Antimicrobial stewardship in long term care facilities: evidence based interventions, implementation tools, and impact metrics.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2026Review
- Leveraging the McGeer Criteria to Estimate the Frequency of Inappropriate Antibiotic Prescribing for Urinary and Respiratory Tract Infections Relative to the Onset of the COVID-19 Pandemic at a Skilled Nursing Facility.Antibiotics (Basel, Switzerland) · 2025Article
- Relationship between medication safety-related processes and medication use in residential aged care facilities.Australasian journal on ageing · 2024Article
- A Multifaceted Intervention and Its Effects on Antibiotic Usage in Norwegian Nursing Homes.Antibiotics (Basel, Switzerland) · 2023Article
- Antibiotic Prescribing in United States Nursing Homes, 2013-2017.The Journal of infectious diseases · 2023Article
- National Cohort Study of Homebound Persons Living With Dementia: Antibiotic Prescribing Trends and Opportunities for Antibiotic Stewardship.Open forum infectious diseases · 2022Article
Corrections and comments
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Antibiotics are frequently prescribed in nursing homes; national data describing facility-level antibiotic use are lacking. The objective of this analysis was to describe variability in antibiotic use in nursing homes across the United States using electronic health record orders. Methods: A retrospective cohort study of antibiotic orders for 309,884 residents in 1,664 US nursing homes in 2016 were included in the analysis. Antibiotic use rates were calculated as antibiotic days of therapy (DOT) per 1,000 resident days and were compared by type of stay (short stay ≤100 days vs long stay >100 days). Prescribing indications and the duration of nursing home-initiated antibiotic orders were described. Facility-level correlations of antibiotic use, adjusting for resident health and facility characteristics, were assessed using multivariate linear regression models. Results: In 2016, 54% of residents received at least 1 systemic antibiotic. The overall rate of antibiotic use was 88 DOT per 1,000 resident days. The 3 most common antibiotic classes prescribed were fluoroquinolones (18%), cephalosporins (18%), and urinary anti-infectives (9%). Antibiotics were most frequently prescribed for urinary tract infections, and the median duration of an antibiotic course was 7 days (interquartile range, 5-10). Higher facility antibiotic use rates correlated positively with higher proportions of short-stay residents, for-profit ownership, residents with low cognitive performance, and having at least 1 resident on a ventilator. Available facility-level characteristics only predicted a small proportion of variability observed (Model R Conclusions: Using electronic health record orders, variability was found among US nursing-home antibiotic prescribing practices, highlighting potential opportunities for targeted improvement of prescribing practices.
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Registered trials
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