Infection control in a skilled nursing facility: a 6-year survey.

In 1981 an infection control programme was started in a 320-bed skilled nursing facility in The Netherlands. The programme consisted of recording the antimicrobial drugs prescribed and the site of infection, culture of urine from patients admitted from hospital and from residents with suspected symptomatic urinary tract infection, restriction of long-term indwelling urethral catheterization and restricted use of antimicrobial drugs. At a weekly staff meeting, these data were reviewed. As a result of the programme, the number of treatments for urinary tract infections decreased by 74% between 1981 and 1986, and the number of courses for recurrent urinary tract infections decreased from 18 to 6% of the total number given. The patients who did not require antimicrobial therapy increased from 51% in 1981 to 70% in 1986.