Antibiotic prescribing in nursing homes in an area with low prevalence of antibiotic resistance: compliance with national guidelines.

OBJECTIVE: To examine antibiotic prescribing in nursing homes and determine to what degree the prescribing was in accordance with the national guidelines for antibiotic prescribing.

DESIGN: Retrospective examination of patients' records who were prescribed antibiotics in the period 1 March 2007 to 28 February 2008.

SETTING AND PATIENTS: Patients residing in the nursing homes of Arendal, Norway.

MAIN OUTCOME MEASURES: Choice of antibiotic in respect of the recommendations in the national guidelines for antibiotic prescribing.

RESULTS: A total of 714 antibiotic courses were prescribed to 327 patients yielding a prevalence of 6.6%. Compliant prescribing was 77% for urinary tract infections (UTI), 79% for respiratory tract infections (RTI), and 76% for skin and soft tissue infections (SSTI). Ciprofloxacin was responsible for 63% of non-compliant prescribing. On the respite wards there was a higher rate of total prescribing, non-compliant prescribing, and prescribing by physicians employed at the local hospital.

CONCLUSION: Guidelines for antibiotic use must be implemented actively and efforts to improve antibiotic prescribing in nursing homes must be aimed at both nursing home and hospital physicians.