MEASURING ANTIBIOTIC USE IN A LONG-TERM-CARE FACILITY

Background: In the long-term care facility setting, there is little in formation about correlation of antibiotic use with care delivered or w ith the occurrence of fever or use of Foley catheters. The objectives of this study were to compare various measures of quantitating antibio tic use and to correlate these measures with febrile morbidity and Fol ey catheter use in a hospital-based, long-term care facility. Methods: This was a prospective study in which the number of residents with fe ver (rectal temperature of 100.5 degrees F or greater) or a Foley cath eter was documented daily. Antibiotic use was measured in several ways : incidence (courses per 100 resident care days), proportion of reside nt care days that were antibiotic days, the number of antibiotic cours es per month, and the number of residents treated per month. Results: Between January and December 1989, 111 (71%) of 156 residents were pre scribed 263 antibiotic courses. Incidence of antibiotic use was 0.61 c ourses per 100 resident care days. On average only about 5% of residen t care days per month were associated with antibiotic use, whereas an average of 18 residents per month received antibiotic therapy. Trimeth oprim/sulfa and ciprofloxacin together accounted for 55% of the course s prescribed. No significant correlations were found between any antib iotic use measure and febrile days or Foley catheter days each month. Conclusions: In the long-term care facility setting, monitoring the nu mber of residents treated with antibiotics per month is a more practic al and useful measure of use than measurement of resident care days on antibiotics per month.