Study: Overuse of antibiotics in RI nursing homes

A recently published study out of Brown documented antibiotic overuse for urinary tract infection in nursing homes and came up with this understated conclusion: Opportunities exist to improve provider practice related to the appropriate treatment of urinary tract infections in the nursing home.

 More here from Reuters.

Two out of every five residents with urinary problems got inappropriate drugs, researchers found, which in turn increased their chance of getting a bacterial infection.

“We tend to over-utilize antibiotics, many times if family or the nursing home requests them,” said Dr. David Dosa of Brown University in Providence, Rhode Island, who worked on the study.

Why is this a problem? See the CDC’s “Fast Facts” on antibiotic resistance. For example:

 
 More here from NYTimes “New Old Age” column.

“One of the most important findings, and other studies show similar results, is that undertreatment didn’t hurt anybody,” Dr. Dosa said. “Nobody in our sample who didn’t get an antibiotic had a bad outcome,” like a kidney infection, hospitalization or death. But those patients who were overtreated — that is, given antibiotics when their symptoms didn’t fit the criteria — were far more likely to be struck by the virulent and dangerous C. difficile bacterium, which flourishes in the gut when patients’ own competing bacteria have been eliminated by potent drugs.

“That allows some of these superbugs to take over, and they’re much harder to eradicate,” Dr. Dosa said. “It’s become an epidemic over the course of the last decade.”

Moreover, bacteria that develop resistance to antibiotics can plague not only old people but, despite infection control measures, their visitors and caregivers and the patient down the hall.

  • Antibiotic resistance has been called one of the world’s most pressing public health problems.
  • The number of bacteria resistant to antibiotics has increased in the last decade. Many bacterial infections are becoming resistant to the most commonly prescribed antibiotic treatments.
  • Every time a person takes antibiotics, sensitive bacteria are killed, but resistant germs may be left to grow and multiply. Repeated and improper uses of antibiotics are primary causes of the increase in drug-resistant bacteria.
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