Consideration for the appropriate use of antimicrobials in long-term care wards.

BACKGROUND

Few studies have been conducted on the appropriate use of antimicrobials in long-term care wards, where patients with advanced neuromuscular disorders or severe motor and intellectual disabilities have been hospitalized for an extended period. This study aimed to confirm the clinical conditions requiring antibiotics in long-term care wards.

METHODS

Electronic medical records of patients who were administered intravenous infusions between 1st January 2018 and 31st December 2020 were retrospectively reviewed. The treatment methods were compared between two periods: from 1st January 2018 to 30th June 2019 (usual treatment group) and from 1st July 2019 to 31st December 2020 (optimal treatment group, based on the principles of antimicrobial stewardship).

RESULTS

Data from 65 patients (23 females, 42 males) with a mean age of 38 years and a median length of hospitalization stay of 14.5 years were analysed. A total of 206 intravenous infusions were administered, 86 in the usual treatment group and 120 in the optimal treatment group, of which 32 (37.2%) and 28 (23.3%) involved antibiotic therapy, respectively (P = 0.04). A significant difference was observed in the diagnosis of aspiration or respiratory tract infections (P < 0.01). Moreover, the peak level of C-reactive protein (CRP) during the event was identified as an important indicator.

CONCLUSION

A comprehensive evaluation of patient status and CRP levels may help reduce inappropriate antibiotic use in long-term care wards.