Antibiotics are used often in nursing homes in response to high rates
of infection. Physicians and nursing home administrators and staff nee
d to work in concert to avoid inappropriate prescription of antibiotic
s in this setting. Physicians need to know how infection presents in f
rail, institutionalized elderly patients; strive to prevent infection;
and prescribe antibiotics only in situations in which clear benefit h
as been demonstrated. Nursing home administrators and staff must insti
tute comprehensive infection control programs, adopt specific guidelin
es for antibiotic use, and keep physicians informed about the number a
nd types of infections and antibiotic susceptibility patterns.