Antibiotic prescribing in UK care homes 2016-2017: retrospective cohort study of linked data.

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  • Additional Information
    • Corporate Authors:
      Preserving Antibiotics through Safe Stewardship group
    • Source:
      Publisher: BioMed Central Country of Publication: England NLM ID: 101088677 Publication Model: Electronic Cited Medium: Internet ISSN: 1472-6963 (Electronic) Linking ISSN: 14726963 NLM ISO Abbreviation: BMC Health Serv Res Subsets: MEDLINE
    • Publication Information:
      Original Publication: London : BioMed Central, [2001-
    • Subject Terms:
      Anti-Bacterial Agents/*administration & dosage ; Homes for the Aged/*statistics & numerical data ; Nursing Homes/*statistics & numerical data ; Practice Patterns, Physicians'/*statistics & numerical data; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Retrospective Studies ; Semantic Web ; United Kingdom
    • Abstract:
      Background: Older people living in care homes are particularly susceptible to infections and antibiotics are therefore used frequently for this population. However, there is limited information on antibiotic prescribing in this setting. This study aimed to investigate the frequency, patterns and risk factors for antibiotic prescribing in a large chain of UK care homes.
      Methods: Retrospective cohort study of administrative data from a large chain of UK care homes (resident and care home-level) linked to individual-level pharmacy data. Residents aged 65 years or older between 1 January 2016 and 31 December 2017 were included. Antibiotics were classified by type and as new or repeated prescriptions. Rates of antibiotic prescribing were calculated and modelled using multilevel negative binomial regression.
      Results: 13,487 residents of 135 homes were included. The median age was 85; 63% residents were female. 28,689 antibiotic prescriptions were dispensed, the majority were penicillins (11,327, 39%), sulfonamides and trimethoprim (5818, 20%), or other antibacterials (4665, 16%). 8433 (30%) were repeat prescriptions. The crude rate of antibiotic prescriptions was 2.68 per resident year (95% confidence interval (CI) 2.64-2.71). Increased antibiotic prescribing was associated with residents requiring more medical assistance (adjusted incidence rate ratio for nursing opposed to residential care 1.21, 95% CI 1.13-1.30). Prescribing rates varied widely by care home but there were no significant associations with the care home-level characteristics available in routine data.
      Conclusions: Rates of antibiotic prescribing in care homes are high and there is substantial variation between homes. Further research is needed to understand the drivers of this variation to enable development of effective stewardship approaches that target the influences of prescribing.
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    • Grant Information:
      MR/K006584/1 United Kingdom MRC_ Medical Research Council; ES/P008321/1 Economic and Social Research Council (GB)
    • Contributed Indexing:
      Investigator: N Anderson; L Atkins; A Conolly; E Crayton; S Denaxas; P Dutey-Magni; N Elsay; G Forbes; EB Fragaszy; N Freemantle; C Fuller; M Gill; AH Hayward; R Horne; A Jhass; P Kostkova; F Lorencatto; S Michie; J Mindell; M Richardson; J Robson; P Rockenschaub; C Royston; LJ Shallcross; CM Smith; E Sutton; J Thomas; C Tarrant; R Traina; E Richardson; J West; H Williams
      Keywords: Anti-bacterial agents; Antibiotic prescribing; Antibiotic stewardship; Infection; Long-term care; Older people; care home
    • Accession Number:
      0 (Anti-Bacterial Agents)
    • Publication Date:
      Date Created: 20200620 Date Completed: 20201211 Latest Revision: 20240329
    • Publication Date:
      20240329
    • Accession Number:
      PMC7301534
    • Accession Number:
      10.1186/s12913-020-05422-z
    • Accession Number:
      32552886