Findings are from largest dataset published to date across the UK

 

New UK-wide research, led by Boots UK has been published, looking into the use of antibiotics in care and residential homes (Long Term Care Facilities, LTCFs) across the UK. The research highlights the use of antibiotics in LTCFs and identifies potential gaps in knowledge and support for carers and residents when using antibiotics, with the aim of looking at how community pharmacy can provide additional support.

Antimicrobial resistance (AMR) is a major public health problem, causing patient safety issues for individual and health systems worldwide[1]. Residents in LTCFs are associated with higher rates of antibiotics use, particularly for urinary tract infections (UTIs)[2] which are frequently associated with antibiotic resistant organisms that can lead to treatment failure and blood stream infections. NHS improvement schemes in England currently focus on reducing inappropriate antibiotic prescribing by 50% by 2021, and improving the primary care management of UTIs to reduce the risk of E.coli blood stream infections[3].

A survey (point prevalence survey, PPS) was conducted by community pharmacists in November and December 2017 where data were collected for almost 18,000 residents across over 600 LTCFs in the UK. Whilst these results only provide a snapshot in time of antibiotic use within LTCFs, they are the largest dataset published to date across the UK[4].

The results of the PPS showed that more than two thirds (66.8%) of all LTCFs visited had a least one resident on antibiotics on the day of the visit.

Marc Donovan, Chief Pharmacist at Boots UK, said: “The results of this survey show there is a role for pharmacy teams working in collaboration within the LTCF environment to provide a greater focus on antimicrobial stewardship, supporting the national ambition to reduce inappropriate prescribing by 50% by 2021.

“This should include ongoing training and support for carers on self-care for residents, such as practical advice on how to support residents in taking antibiotics such as timings and dose form.”

The research paper, titled ‘Antimicrobial use in UK long-term care facilities: results of a point prevalence survey’, was co-authored by researchers at Boots UK, Public Health England and NHS Improvement.

It has been published in the Journal of Antimicrobial Chemotherapy (JAC). The full paper can be found here

 

[1] Infections globally: Final report and recommendations, the review on antimicrobial resistance, 2016. Welcome Trust. https://amrreview.org/sites/default/files/160525_Final%20paper_with%20cover.pdf

[2] Sundvall PD, Stuart B, Davis M et al. Antibiotic use in the care home setting: a retrospective cohort study analysing routine data. BMC Geriatrics 2015; 15:71

[3] Quality Premium. NHS England https://www.england.nhs.uk/ccg-out-tool/qual-prem/

[4] NHS National services Scotland. National Point Prevalence Survey of Healthcare Associated Infection and Antimicrobial Prescribing in Long Term Care Facilities, 2017. Health Protection Agency.   file://centre1/user/Home/T/tracey.thornley/Documents/Pharmacy%20Development/Research/Care%20homes/Audit%20data%20paper/Scottish%20PP%20survey%20care%20homes%202017.pdf