Antibiotic use, and misuse, in the nation's nursing homes has long been a concern for infectious disease professionals and antibiotic resistance experts.

According to the Centers for Disease Control and Prevention, an estimated 70% of nursing home residents receive one or more courses of antibiotics a year. The primary reasons for such frequent antibiotic use in long-term care is that residents are often frail and have underlying conditions that make them more vulnerable to bacterial infections, especially those involving the skin, urinary tract, and respiratory tract.

Yet studies have shown that anywhere from 40% to 75% of the antibiotics prescribed in nursing homes may be inappropriate, resulting in increased risk of adverse drug reactions, Clostridioides difficile infections, and colonization or infection with antibiotic-resistant organisms.

One group that is particularly susceptible to infections, and antibiotics, are residents with Alzheimer's or advanced dementia. This population presents a particular challenge for antibiotic stewardship for a variety of reasons, says Susan Mitchell, MD, MPH, a professor of medicine at Harvard Medical School and director of palliative care research at the Marcus Institute for Aging Research.

Read more at CIDRAP...