Ramon Monfà, Ana García-Sangenís, Rosa Morros, Carlota Manuela Zárate Sáez, Jesús Mateos-Nozal, María N Vaquero Pinto, Carmen Sáez Bejar, Elena López Pérez, Consuelo Rodríguez Jiménez, Rosa Magallón-Botaya, Priscila Matovelle, Alicia Navarro Sanmartín, Carl Llor
{"title":"对西班牙养老院常见感染抗生素使用的多方面干预的影响。A学习前后。","authors":"Ramon Monfà, Ana García-Sangenís, Rosa Morros, Carlota Manuela Zárate Sáez, Jesús Mateos-Nozal, María N Vaquero Pinto, Carmen Sáez Bejar, Elena López Pérez, Consuelo Rodríguez Jiménez, Rosa Magallón-Botaya, Priscila Matovelle, Alicia Navarro Sanmartín, Carl Llor","doi":"10.1007/s41999-025-01193-0","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.5000,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The impact of a multifaceted intervention on antibiotic use for common infections in nursing homes in Spain. 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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.</p><p><strong>Results: </strong>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). 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The impact of a multifaceted intervention on antibiotic use for common infections in nursing homes in Spain. A before and after study.
Purpose: 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.
Methods: 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.
Results: 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.
Conclusion: 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.
期刊介绍：
European Geriatric Medicine is the official journal of the European Geriatric Medicine Society (EUGMS). Launched in 2010, this journal aims to publish the highest quality material, both scientific and clinical, on all aspects of Geriatric Medicine.
The EUGMS is interested in the promotion of Geriatric Medicine in any setting (acute or subacute care, rehabilitation, nursing homes, primary care, fall clinics, ambulatory assessment, dementia clinics..), and also in functionality in old age, comprehensive geriatric assessment, geriatric syndromes, geriatric education, old age psychiatry, models of geriatric care in health services, and quality assurance.
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