[img_inline align=”right” src=”http://padnws01.mcmaster.ca/images/Loeb_Mark.jpg” caption=”Mark Loeb, an infectious disease specialist in the Michael G. DeGroote School of Medicine at McMaster University and principal investigator of the study.”]The inappropriate use of antimicrobials in healthcare facilities has long been recognized as an important problem, particularly in long-term care facilities. Important consequences of this include the emergence of bacterial resistance, side effects, and increased costs.

A new study by McMaster researchers has found that the use of treatment guidelines in cases of suspected urinary tract infections resulted in fewer antibiotics given to patients in nursing homes. The study has been published as an online first article by the British Medical Journal at www.bmj.com.

“The less often we use antibiotics the farther ahead we are in allowing antimicrobial resistant bacteria to develop,” said Mark Loeb, an infectious disease specialist in the Michael G. DeGroote School of Medicine at McMaster University and principal investigator of the study.

In a randomized controlled trial of 24 nursing homes in Ontario, Canada, and Idaho, United States, participants in 12 nursing homes were allocated to a multifaceted intervention for diagnosing and treating urinary tract infections, and 12 were allocated to the usual care. In total, 4,217 nursing home residents participated.

The step-by-step multifaceted approach included small group interactive sessions for nurses, videotapes, written material, outreach visits, and one-on-one interviews with physicians.

Results of the study showed that in the intervention homes, fewer prescriptions for antibiotics for suspected urinary tract infections were ordered, than in the usual care homes and there was no significant difference in admissions to hospital or death between the nursing homes in the study.

Prescriptions for antibiotics for suspected urinary tract infections represented 28.4 percent of all drug prescriptions in the intervention nursing homes, compared with 38.6 percent in the usual care homes.

“This study indicates that if a consistent step-by-step intervention for diagnosing and treating urinary tract infections in nursing home patients is implemented, less antibiotics will be prescribed and the opportunities for development of antibiotic resistant bacteria, as well as other adverse effects, will be reduced,” said Loeb.