Recommendations for Improving Antimicrobial Stewardship in Long-Term Care Settings Through Collaboration

Cullen Adre; Robin L P Jump; Steven Schaeffer Spires

doi:10.1016/j.idc.2019.10.007

Recommendations for Improving Antimicrobial Stewardship in Long-Term Care Settings Through Collaboration

Infect Dis Clin North Am. 2020 Mar;34(1):129-143. doi: 10.1016/j.idc.2019.10.007.

Authors

Cullen Adre¹, Robin L P Jump², Steven Schaeffer Spires³

Affiliations

¹ Tennessee Department of Health, Andrew Johnson Tower, 3.417C, 710 James Robertson Parkway, Nashville, TN 37243, USA. Electronic address: Cullen.adre@tn.gov.
² Geriatric Research Education and Clinical Center (GRECC); Specialty Care Center of Innovation at the VA Northeast Ohio Healthcare System, Cleveland, OH, USA; Division of Infectious Diseases and HIV Medicine, Department of Medicine, Case Western Reserve University School of Medicine, 10900 Euclid Avenue, Cleveland, OH 44106, USA; Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, 10900 Euclid Avenue, Cleveland, OH 44106, USA.
³ Duke Center for Antimicrobial Stewardship and Infection Prevention, Division of Infectious Diseases, Duke University School of Medicine, DUMC PO Box 102359, Durham, NC 27710, USA.

PMID: 32008695
DOI: 10.1016/j.idc.2019.10.007

Abstract

Antimicrobial stewardship is a collaborative venture and antimicrobial stewardship in long-term care (LTC) settings is no exception. There are many barriers to implementing effective antimicrobial stewardship programs in LTC settings, including constrained financial resources, limited access to physicians and pharmacists with antimicrobial stewardship training, minimal on-site infectious syndrome diagnostics and laboratory expertise, and high rates of staff turnover. This article suggests that collaboration at the level of health care facilities and systems, with public health departments, with laboratory partners, and among personnel, including nursing staff, prescribers, and pharmacists, can lead to effective antimicrobial stewardship programs in LTC settings.

Keywords: Antibiotic resistance; Antimicrobial stewardship; Clostridioides difficile; Collaboration; Long-term care facilities.

Published by Elsevier Inc.

Publication types

Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.
Review

MeSH terms

Anti-Bacterial Agents / therapeutic use
Antimicrobial Stewardship / methods*
Antimicrobial Stewardship / organization & administration
Communicable Diseases / drug therapy
Health Plan Implementation / methods*
Humans
Intersectoral Collaboration*
Long-Term Care*
Physicians

Substances

Anti-Bacterial Agents