The impact of a multifaceted intervention on antibiotic use for common infections in nursing homes in Spain. A before and after study
Monfà, Ramon (Universitat Autònoma de Barcelona)
Garcia-Sangenis, Ana (Universitat Autònoma de Barcelona)
Morros, Rosa (Universitat Autònoma de Barcelona)
Llor, Carl (Universitat Autònoma de Barcelona)
Mateos-Nozal, Jesús (Hospital Universitario Ramón y Cajal (Madrid))
Vaquero Pinto, María N. (Hospital Universitario Ramón y Cajal (Madrid))
Sáez Bejar, Carmen (Hospital Universitario de la Princesa (Madrid))
López Pérez, Elena (Institut Català de la Salut)
Rodríguez Jiménez, Consuelo (Hospital Universitario de Canarias (La Laguna))
Magallon Botaya, Rosa (Universidad Zaragoza)
Matovelle, Priscila (Hospital San Juan de Dios (Saragossa))
Navarro Sanmartín, Alicia (Aragon Institute of Social Services (IASS) (Borja, Saragossa))
Llor, Carl (University of Southern Denmark)

Fecha:	2025
Resumen:	Evaluate nursing staff intervention's impact on antibiotic use and hygiene for nursing home residents' infections. A 2-h intervention for nursing staff, involving individual and group feedback, evidence-based infection management, and infection prevention techniques, improved prescription appropriateness for common infections in nursing homes. The intervention was effective, but a more comprehensive educational program is required. The online version contains supplementary material available at 10. 1007/s41999-025-01193-0. The aim of this study was to assess the impact of a multifaceted intervention aimed at nursing home staff on antibiotic use and hygiene elements for nursing home residents with common infections. Before-and-after study carried out in nursing homes in five areas of Spain. Nursing staff registered residents with common infections and documented hygiene practices over three months, before and after a 2-h educational intervention in autumn 2023. The intervention focused on the initial registration results, antibiotic guidelines, infection prevention, and management strategies for nursing homes. Indicators for potentially unnecessary antibiotic use and non-first-line antibiotics were developed, and results from both registration periods (Feb-Apr 2023 and Feb-Apr 2024) were compared to assess impact. Of 34 nursing homes, 23 completed the intervention and the two registrations (67. 6%). Staff reported 1003 infections in the first registration and 789 in the second. The overall antibiotic prescription rate was 84. 6%. Potentially inappropriate antibiotic use for urinary tract infections decreased from 70. 3 to 59. 9% (P < 0. 005) and use for respiratory infections dropped from 78. 1 to 62. 7% (P < 0. 001), with inappropriate use decreasing from 46. 3 to 31% (P < 0. 001). The mean duration of antibiotics for cystitis reduced from 7 to 5. 4 days (P < 0. 05). The intervention had no impact on hygiene practices. Potentially unnecessary antibiotic use was lower after the intervention, whereas hygiene practices were unchanged. A more intensive, multifaceted educational approach is needed for a greater impact. The online version contains supplementary material available at 10. 1007/s41999-025-01193-0.
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Nursing homes ; Frail elderly ; Hygiene ; Antimicrobial stewardship ; Medical audit ; Overdiagnosis ; Anti-bacterial agents
Publicado en:	European Geriatric Medicine, Vol. 16 (april 2025) , p. 1465-1473, ISSN 1878-7657

DOI: 10.1007/s41999-025-01193-0
PMID: 40261575

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