Reliability of nonlocalizing signs and symptoms as indicators of the presence of infection in nursing-home residents
Theresa A. Rowe, Robin Jump, Bjørg Marit Andersen, David Banach, Kristina A. Bryant, Sarah B. Doernberg, Mark Loeb, Deborah Morgan, Andrew M. Morris, Rekha Murthy, David A. Nace, Christopher J. Crnich
Abstract
Antibiotics are among the most common medications prescribed in nursing homes. The annual prevalence of antibiotic use in residents of nursing homes ranges from 47% to 79%, and more than half of antibiotic courses initiated in nursing-home settings are unnecessary or prescribed inappropriately (wrong drug, dose, or duration). Inappropriate antibiotic use is associated with a variety of negative consequences including Clostridioides difficile infection (CDI), adverse drug effects, drug-drug interactions, and antimicrobial resistance. In response to this problem, public health authorities have called for efforts to improve the quality of antibiotic prescribing in nursing homes.