Prescribing in a Long Term Care Facility / Nursing Homes

Successive HALT studies in long-term care facilities (in 2010, 2012, 2013 & 2016) have shown that Irish Nursing home residents are prescribed far more antibiotics than their European counterparts. Antibiotics are most commonly prescribed for urinary tract infection (UTI), respiratory tract infection (RTI) and skin and soft tissue infection (SSTI).

These findings were echoed and expanded upon in an antibiotic point prevalence survey conducted by CHO-based antimicrobial pharmacists in HSE Older Persons residential care facilities between October and December 2020. This study found that:

Useful Information

  • Superbugs including CPE
    • In October 2017, the Minister for Health declared a public health emergency in relation to CPE This GP CPE toolkit contains a number of documents including guidelines for general practice, guidance for healthcare staff visiting patients at home, a set of facts sheets on CPE and patient information. We are developing more specific target guidance on nursing homes including dipstick and MSU polices for local adaptation but in the interim there is lots of useful relevant guidance already on our website

RTI

SSTI

Other

Safe Prescribing:

Patients in nursing homes or other long-term care facilities may be particularly frail or have other co-morbidities. Presence of polypharmacy, dysphagia, renal impairment and antibiotic resistance can be common. These factors are important considerations in selecting the optimal antibiotic agent and dosing regimen as they may influence the effects, side-effects and frequency of drug interactions of any antibiotic prescribed.

Reviewed May 2021