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8 April 2019 /

Care home residents much more likely to be prescribed antibiotics 

The odds of the elderly being prescribed antibiotics are at least twice as high in care homes as they are in the community, a study has found 

Researchers discovered 74 per cent of those living in care homes were found to have been given at least one antibiotic during 2012 compared to 49 per cent in the community. Once the data was adjusted to take account of influencing factors on people living in care homes, such as increased frailty, age, and co-morbidities, it revealed a 2.05 times increase in antibiotic prescription. This could increase the risk of antimicrobial resistance in the care home setting, the study’s authors said.  

The study was carried out by researchers in Northern Ireland in conjunction with the Public Health Agency and Queen’s University Belfast, between January 1, 2012 and December 31, 2013. Researchers reviewed available medical data for over 265,000 residents in Northern Ireland aged 65 and over.  

Dr Lynsey Patterson, one of the authors, said: “The development of antibiotics in the last century revolutionised medicine and enabled us to treat serious infections. However, we now use more antibiotics than we need to. This makes bacteria resistant and antibiotics less and less effective at treating the serious bacterial infections they are needed for. 

“If we continue to use antibiotics at the current rate, we could face a return to the days before antibiotics, when people died from minor infections and where the risk of infection made routine surgery life threatening. For this reason, antibiotic resistance is a threat to everyone’s health.” 

The researchers found that the number of people prescribed an antibiotic increased in the month preceding and the month following entrance to a care home. The data showed that 15.5 per cent of those included in the study had been prescribed antibiotics in the five months before going to a care home. Six months after admission, that percentage had increased to 23.3 per cent – a proportionate increase of 51.5 per cent.  

In the paper, which has been published in the journal of Epidemiology and Infection, the authors acknowledged that the frailty of those living in care homes went some way in explaining the higher prescription of antibiotics there, but they were not convinced by that factor alone. 

Dr Patterson said: “Care homes are very complex environments which cater for residents often with complex needs. One reason that prescribing may increase is therefore because there is a need - that is, the residents are more prone to infection than their counterparts who remain in the community.  

“An alternative reason may be that some of the prescribing is inappropriate and there is evidence of this from other studies. We were unable to explore this in our study because we did not have access to the reason why the antibiotic was prescribed, but this does warrant further investigation.” 

Prescription methods differ between community and care home settings. Older people living in the community will typically be assessed by a GP in a face

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