An analysis of antibiotic prescribing in long-term care facilities in Canada by Nick Daneman, MD, MSc, of the University of Toronto, Canada, and colleagues suggests that antibiotic treatment courses are often prescribed for long durations and seem to be influenced by prescriber preference more than patient characteristics.
Of 66,901 long-term care residents from 630 facilities, 50,061 (77.8 percent) received an incident antibiotic treatment course. The most commonly prescribed course was seven days (21,136 courses, 41 percent), but 23,124 courses (44.9 percent) exceeded seven days. Among the 699 physicians responsible for 20 or more antibiotic treatment courses, the median (midpoint) proportion of treatment courses beyond seven days was 43.5 percent, according to study results.
Future trials should evaluate antibiotic stewardship interventions targeting prescriber preferences to systematically shorten average treatment durations to reduce the complications, costs and resistance associated with antibiotic overuse, the study concludes.
Reference: JAMA Intern Med. Published online March 18, 2013. doi:10.1001/jamainternmed.2013.3029.