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Modest Association between Antibiotic and Antipsychotic Prescribing Rates in Nursing Homes

  • Sunah Song
    Affiliations
    Cleveland Institute for Computational Biology, Cleveland, OH, USA
    Department of Computer and Data Sciences, School of Engineering, Case Western Reserve University, Cleveland, OH, USA
    Department of Population and Quantitative Health Sciences, School of Medicine, Case Western Reserve University, Cleveland, OH, USA
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  • Brigid M. Wilson
    Affiliations
    Division of Infectious Diseases & HIV Medicine in the Department of Medicine, School of Medicine, Case Western Reserve University, Cleveland, OH, USA
    Geriatric Research Education and Clinical Center (GRECC) at the VA Northeast Ohio Healthcare System, Cleveland, OH, USA
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  • Joseph Marek
    Affiliations
    CommuniCare Health Services, Cincinnati, OH, USA
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  • Robin L.P. Jump
    Correspondence
    Address correspondence to Robin L.P. Jump, MD, PhD, GRECC 111C(W), VA Northeast Ohio Healthcare System, 10701 East Blvd, Cleveland, OH 44106, USA.
    Affiliations
    Department of Population and Quantitative Health Sciences, School of Medicine, Case Western Reserve University, Cleveland, OH, USA
    Division of Infectious Diseases & HIV Medicine in the Department of Medicine, School of Medicine, Case Western Reserve University, Cleveland, OH, USA
    Geriatric Research Education and Clinical Center (GRECC) at the VA Northeast Ohio Healthcare System, Cleveland, OH, USA
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Published:October 06, 2021DOI:https://doi.org/10.1016/j.jamda.2021.08.043
      In nursing homes, practitioners' preferences, rather than residents’ signs and symptoms or overall medical conditions, have been identified as important drivers of antibiotic use.
      • Phillips C.D.
      • Adepoju O.
      • Stone N.
      • et al.
      Asymptomatic bacteriuria, antibiotic use, and suspected urinary tract infections in four nursing homes.
      • Daneman N.
      • Gruneir A.
      • Bronskill S.E.
      • et al.
      Prolonged antibiotic treatment in long-term care: Role of the prescriber.
      • Daneman N.
      • Campitelli M.A.
      • Giannakeas V.
      • et al.
      Influences on the start, selection and duration of treatment with antibiotics in long-term care facilities.
      Similar to antibiotics, antipsychotics also pose notable risks to residents and are subject to inappropriate prescribing practices. We recently reported that, in addition to resident acuity, the number of unique practitioners in a nursing home positively correlates with the rate of antibiotic starts.
      • Song S.
      • Wilson B.M.
      • Bej T.
      • et al.
      Antibiotic use among residents receiving skilled nursing care in 29 U.S. nursing homes.
      This observation aligned with previous evidence that providers and their practice patterns drive antibiotic use in nursing home settings. We hypothesized that nursing home practitioners with injudicious antibiotic use may display a similar practice pattern for antipsychotics as these are also agents that may be issued because of a change in condition.
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