Aysu Selcuk1, Kai Zhen Yap1, Chee Liang Wong1, Jing Xi Yang1, Pei Chean Yong2, Sui Yung Chan1, Christine B Teng3. 1. Department of Pharmacy, Faculty of Science, National University of Singapore, 18 Science Drive 4, Block S4A, Level 3, Singapore, 117543, Republic of Singapore. 2. Intermediate- and Long-Term Care Workgroup, Pharmaceutical Society of Singapore, Singapore, Republic of Singapore. 3. Department of Pharmacy, Faculty of Science, National University of Singapore, 18 Science Drive 4, Block S4A, Level 3, Singapore, 117543, Republic of Singapore. christeng@nus.edu.sg.
Abstract
BACKGROUND: Inappropriate antimicrobial use is a major cause for the development of antimicrobial resistance in nursing homes (NHs); however, little is known about antimicrobial use at NHs in Singapore compared with NHs in other countries. OBJECTIVES: The aim of this study was to determine the prevalence, practice and challenges of antimicrobial prescribing in Singapore NHs compared with those in other countries. METHODS: A point prevalence survey (PPS) was conducted from August to October 2017. Data on antimicrobial use and the quality of documentation were retrieved from medical and/or medication records of NH residents. Informed consent was obtained from the NH management. RESULTS: Nine of 73 NHs in Singapore, with a total of 1760 residents, participated in the PPS. The prevalence of oral antibiotic and topical antimicrobial use was 2% and 11%, respectively, and the worldwide point prevalence of antimicrobial prescribing in NHs ranged from 1-17% (median 8%). The key challenges identified locally were different from those of overseas NHs, including incomplete documentation of antimicrobial duration and indication of use, as well as the high prevalence of topical antimicrobial use. CONCLUSIONS: The prevalence of oral antibiotic use in NHs in Singapore was lower, while topical antimicrobial use was higher, compared with NHs in other countries. Variability in antimicrobial prescribing and challenges in practice among local and overseas NHs implied that a comprehensive PPS could be beneficial to aid in the design of effective and practicable antimicrobial stewardship strategies appropriate for the NH.
BACKGROUND: Inappropriate antimicrobial use is a major cause for the development of antimicrobial resistance in nursing homes (NHs); however, little is known about antimicrobial use at NHs in Singapore compared with NHs in other countries. OBJECTIVES: The aim of this study was to determine the prevalence, practice and challenges of antimicrobial prescribing in Singapore NHs compared with those in other countries. METHODS: A point prevalence survey (PPS) was conducted from August to October 2017. Data on antimicrobial use and the quality of documentation were retrieved from medical and/or medication records of NH residents. Informed consent was obtained from the NH management. RESULTS: Nine of 73 NHs in Singapore, with a total of 1760 residents, participated in the PPS. The prevalence of oral antibiotic and topical antimicrobial use was 2% and 11%, respectively, and the worldwide point prevalence of antimicrobial prescribing in NHs ranged from 1-17% (median 8%). The key challenges identified locally were different from those of overseas NHs, including incomplete documentation of antimicrobial duration and indication of use, as well as the high prevalence of topical antimicrobial use. CONCLUSIONS: The prevalence of oral antibiotic use in NHs in Singapore was lower, while topical antimicrobial use was higher, compared with NHs in other countries. Variability in antimicrobial prescribing and challenges in practice among local and overseas NHs implied that a comprehensive PPS could be beneficial to aid in the design of effective and practicable antimicrobial stewardship strategies appropriate for the NH.
Authors: Katrien Latour; Boudewijn Catry; Elisabeth Broex; Vanessa Vankerckhoven; Arno Muller; Rudi Stroobants; Herman Goossens; Béatrice Jans Journal: Pharmacoepidemiol Drug Saf Date: 2012-01-24 Impact factor: 2.890
Authors: Nicola D Thompson; Lisa LaPlace; Lauren Epstein; Deborah Thompson; Ghinwa Dumyati; Cathleen Concannon; Gail Quinlan; Tory Witten; Linn Warnke; Ruth Lynfield; Meghan Maloney; Richard Melchreit; Nimalie D Stone Journal: J Am Med Dir Assoc Date: 2016-10-14 Impact factor: 4.669
Authors: Nick Daneman; Andrea Gruneir; Susan E Bronskill; Alice Newman; Hadas D Fischer; Paula A Rochon; Geoff M Anderson; Chaim M Bell Journal: JAMA Intern Med Date: 2013-04-22 Impact factor: 21.873