Work

The impact of a multifaceted intervention on antibiotic use for common infections in nursing homes in Spain. A before and after study

Year: 2025

Type: article

Abstract: PURPOSE: The aim of this study was to assess the impact of a multifaceted intervention aimed at nursing home staff on antibiotic use and hygiene elements for nursing home residents with common infections. METHODS: Before-and-after study carried out in nursing homes in five areas of Spain. Nursing staff registered residents with common infections and documented hygiene practices over three months, before and after a 2-h educational intervention in autumn 2023. The intervention focused on the initial registration results, antibiotic guidelines, infection prevention, and management strategies for nursing homes. Indicators for potentially unnecessary antibiotic use and non-first-line antibiotics were developed, and results from both registration periods (Feb-Apr 2023 and Feb-Apr 2024) were compared to assess impact. RESULTS: Of 34 nursing homes, 23 completed the intervention and the two registrations (67.6%). Staff reported 1003 infections in the first registration and 789 in the second. The overall antibiotic prescription rate was 84.6%. Potentially inappropriate antibiotic use for urinary tract infections decreased from 70.3 to 59.9% (P < 0.005) and use for respiratory infections dropped from 78.1 to 62.7% (P < 0.001), with inappropriate use decreasing from 46.3 to 31% (P < 0.001). The mean duration of antibiotics for cystitis reduced from 7 to 5.4 days (P < 0.05). The intervention had no impact on hygiene practices. CONCLUSION: Potentially unnecessary antibiotic use was lower after the intervention, whereas hygiene practices were unchanged. A more intensive, multifaceted educational approach is needed for a greater impact.

Source: European Geriatric Medicine

DOI: 10.1007/s41999-025-01193-0