ArticleAge and ageing2025
Antibiotic prescribing for care-home residents: a population-based, cross-classified multilevel analysis in Scotland, UK.
Article in Age and ageing, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Population-Level Uncoupling of Antimicrobial Usage and Resistance in Community-OnsetPathogens (Basel, Switzerland) · 2026Article
- Behavioural Determinants of Appropriate Antibiotic Prescribing for Urinary Tract Infections in Nursing Homes: A Qualitative Study of Stakeholders' Perspectives.Antibiotics (Basel, Switzerland) · 2025Article
- Yonder: Screening for atrial fibrillation, antibiotics in care homes, hand, foot, and mouth disease, and asthma triple therapy.The British journal of general practice : the journal of the Royal College of General Practitioners · 2025Article
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThere is wide variation in antibiotic prescribing across care-homes for older people, with implications for resident outcomes and antimicrobial resistance.
objectiveTo quantify variation in antibiotic prescribing and associations with resident, care-home and general practice characteristics.
designPopulation-based analyses using administrative data. SETTING AND SUBJECTS: 148 care-homes in two Scottish regions, with 6633 residents registered with 139 general practices.
methodsPrescriptions for any antibiotic and for broad-spectrum antibiotics between 1 April 2016 and 31 March 2017 were analysed using cross-classified multilevel negative binomial regression.
resultsFor any antibiotics, the mean prescription rate was 6.61 (SD 3.06) per 1000 resident bed-days (RBD). In multivariate analysis, prescribing was associated with resident age [incidence rate ratio (IRR) 1.30 [95% confidence interval 1.19 to 1.41] for 90+ versus <80 years old] and comorbidity (1.88 [1.71 to 2.06] for Charlson Comorbidity Index 3+ versus 0), and the care-home's sampling rate for microbiological culture (1.53 [1.28 to 1.84] for >7 versus <3.5 samples per 1000 RBD), with residual unexplained variation between care-homes (median IRR 1.29 [1.23 to 1.36]) and general practices (1.11 [1.05 to 1.18]). For broad-spectrum antibiotics, the mean rate was 0.98 (0.92) per 1000 RBD. Broad-spectrum prescribing was also associated with resident age, sex, comorbidity and sampling rate, with larger residual unexplained variation between care-homes (1.56 [1.36 to 1.77]) and general practices (1.51 [1.31 to 1.72]).
conclusionVariation in prescribing was influenced by resident case-mix, but there is significant unexplained variation between care-homes and between general practices, indicating a need for antibiotic stewardship to target both.
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