Nursing Home Antibiotic Use Linked to High Rate of Problems: Study

Antibiotics are frequently prescribed to many nursing home residents. However, new research suggests that the drugs may be contributing to potentially serious health problems, including gastroenteritis, Clostridium difficile and antibiotic resistant bacteria. 

Researchers from the University of Toronto found one in eight nursing home residents experienced an adverse event related to antibiotic use, regardless of whether they were taking the antibiotics themselves. The findings were published June 29, in the journal JAMA Internal Medicine.

The longitudinal open-cohort study focused on more than 110,000 older adults in 607 different nursing homes in Ontario, Canada, between January 1, 2010, through December 31, 2011.

Researchers found that six percent to 10% of nursing home residents are taking antibiotics at any given time and more than half of them receive at least one antibiotic prescription each year.

Nursing home residents in the highest third of antibiotic use facilities had a 24% higher risk of having antibiotic related adverse events compared to those in the lower two-thirds of the facilities.

Antibiotic related adverse events were found to be more common in residents of high use homes at 13.3%, than among residents of medium use at 12.4% or low use homes 11.4%. The overuse contributes to adverse events, including contributing to the development of superbugs.

Overall researchers found residents were on antibiotics for an average of 20 to 192 days per 1,000 resident days.

Researchers found that high-use nursing homes were linked to an increased risk of residents experiencing antibiotic related adverse events, even residents who did not receive antibiotic treatments experience events.

Antibiotic-related adverse events included Clostridium difficile (C. diff), diarrhea, gastroenteritis, allergic reactions, general medication adverse events and antibiotic-resistant bacteria or superbugs.

The C. diff findings appear to confirm a study published in February, which revealed that the majority of the nearly half a million C. diff infections in the U.S. are hospital acquired infections among older patients taking antibiotics.

C. diff is the most common hospital-acquired infection in the U.S., striking particularly hard at patients ages 65 and older. The infections can cause fatal cases of colon inflammation and diarrhea.

“Residents of high-use homes are exposed to an increased risk of antibiotic-related harms even if they have not directly received these agents,” wrote study authors. “Antibiotic stewardship is needed to improve the safety of all nursing home residents.”

The study comes amid increasing concerns over antibiotic use.

A British Government report released last year warned there would be 10 million deaths each year by 2050 attributable to antibiotic resistant infections unless steps are taken to mitigate the growing risks posed by the overuse of antibiotic drugs.

Earlier this year, drug-resistant superbugs recently made headlines across the country after nearly 200 patients treated at California’s UCLA Medical Center were exposed to a deadly antibiotic-resistant bacteria. The outbreak caused two deaths, seven confirmed infections and was linked to tainted medical equipment, which had undergone normal sterilization treatment.

The U.S. Centers for Disease Control and Prevention (CDC) estimates drug-resistant bacteria, or superbugs, cause 2 million illnesses and approximately 23,000 deaths each year in the United States alone.