Advertisement
In the Trenches| Volume 17, ISSUE 2, P173-178, February 01, 2016

Algorithms Promoting Antimicrobial Stewardship in Long-Term Care

      Antimicrobial stewardship is becoming an increasingly important focus in long-term care settings. The Notice of Proposed Rulemaking, Medicare and Medicaid Programs: Reform of Requirements for Long-Term Care Facilities proposes that facilities must establish an infection prevention and control program, which must include, (among other elements), an antibiotic stewardship program with antibiotic use protocols and a system to monitor antibiotic use.

      Medicare and Medicaid Programs; Reform of Requirements for Long-Term Care Facilities, Centers for Medicare and Medicaid Services, US Department of Health and Human Services. Federal Register, Vol. 80, No. 136, July 16, 2015, P. 42266. Available at: http://federalregister.gov/a/2015-17207. Accessed December 2, 2015.

      Although it is unknown when, or if, the revised requirements will become effective in the proposed format, release of the draft document produced both anxiety and enthusiasm for improving the use of antimicrobial agents in long-term care settings.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of the American Medical Directors Association
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

      1. Medicare and Medicaid Programs; Reform of Requirements for Long-Term Care Facilities, Centers for Medicare and Medicaid Services, US Department of Health and Human Services. Federal Register, Vol. 80, No. 136, July 16, 2015, P. 42266. Available at: http://federalregister.gov/a/2015-17207. Accessed December 2, 2015.

        • CDC
        The Core Elements of Antibiotic Stewardship for Nursing Homes.
        US Department of Health and Human Services, CDC, Atlanta, GA2015 (Available at:) (Accessed December 2, 2015)
        • Daneman N.
        • Bronskill S.E.
        • Gruneir A.
        • et al.
        Variability in antibiotic use across nursing home and the risk of antibiotic-related adverse outcomes for individual residents.
        JAMA Intern Med. 2015; 175: 1331-1339
        • Loeb M.
        • Bentley D.W.
        • Bradley S.
        • et al.
        Development of minimum criteria for the initiation of antibiotics in residents of long-term-care facilities: Results of a consensus conference.
        Inf Control Hosp Epidemiol. 2001; 22: 120-124
      2. Geriatric Pharmaceutical Care Guidelines®, Omnicare, Inc., 2015. Available at: https://gpcg.omnicare.com. Accessed December 2, 2015.

        • Ouslander J.G.
        • Bonner A.
        • Herndon L.
        • Shutes J.
        The INTERACT Quality Improvement Program: An overview for medical directors and primary care clinicians in long-term care.
        J Am Med Dir Assoc. 2014; 15: 162-170
        • Ouslander J.G.
        • Handler S.M.
        Consensus-derived Interventions to Reduce Acute Care Transfer (INTERACT)-compatible order sets for common conditions associated with potentially avoidable hospitalizations.
        J Am Med Dir Assoc. 2015; 16: 524-526

      Linked Article

      • Erratum
        Journal of the American Medical Directors AssociationVol. 18Issue 1
        • Preview
          The authors of the In The Trenches article from the February 2016 issue wish to make a correction to Figure 1 of their article titled, Algorithms Promoting Antimicrobial Stewardship in Long-Term Care (Zarowitz BJ, Allen C, Tangalos E, Ouslander JG, JAMDA 2016;17:173-178). See details of the Figure alterations in our Reply to the Letter to the Editor by Jump RL, et al. in this same issue of the Journal.
        • Full-Text
        • PDF
      • Cloudy, Foul-Smelling Urine Not a Criteria for Diagnosis of Urinary Tract Infection in Older Adults
        Journal of the American Medical Directors AssociationVol. 17Issue 8
        • Preview
          An absence of evidence-based guidelines for the management of commonly encountered infections is a significant barrier to better antibiotic stewardship in the long-term care (LTC) setting. Consequently, the peer-reviewed antimicrobial treatment algorithms developed by Dr. Zarowitz and colleagues as part of Omnicare's Geriatric Pharmaceutical Care Guidelines that were recently published in the Journal1 represent a potentially important contribution to the field.
        • Full-Text
        • PDF