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Antibiotic prescribing and associated diarrhoea: a prospective cohort study of care home residents / D. Gillespie; K. Hood; A. Bayer; B. Carter; D. Duncan; A. Espinasse; M. Evans; J. Nuttall; H. Stanton; A. Acharjya; S. Allen; D. Cohen; S. Groves; N. Francis; R. Howe; A. Johansen; E. Mantzourani; E. Thomas-Jones; A. Toghill; F. Wood; N. Wigglesworth; M. Wootton; C. C. Butler; Samantha Groves

Age and Ageing

Swansea University Author: Samantha, Groves

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DOI (Published version): 10.1093/ageing/afv072

Abstract

Background: the risk factors for and frequency of antibiotic prescription and antibiotic-associated diarrhoea (AAD) among care home residents are unknown.Aim: to prospectively study frequency and risks for antibiotic prescribing and AAD for care home residents.Design and setting: a 12-month prospect...

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Published in: Age and Ageing
Published: 2015
Online Access: http://ageing.oxfordjournals.org/content/early/2015/06/22/ageing.afv072.abstract?keytype=ref&ijkey=XtzcfskPbQ9U5WY
URI: https://cronfa.swan.ac.uk/Record/cronfa22177
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Abstract: Background: the risk factors for and frequency of antibiotic prescription and antibiotic-associated diarrhoea (AAD) among care home residents are unknown.Aim: to prospectively study frequency and risks for antibiotic prescribing and AAD for care home residents.Design and setting: a 12-month prospective cohort study in care homes across South Wales.Method: antibiotic prescriptions and the development of AAD were recorded on case report forms. We defined AAD as three or more loose stools in a 24-h period occurring within 8 weeks of exposure to an antibiotic.Results: we recruited 279 residents from 10 care homes. The incidence of antibiotic prescriptions was 2.16 prescriptions per resident year (95% CI: 1.90–2.46). Antibiotics were less likely to be prescribed to residents from dual-registered homes (OR compared with nursing homes: 0.38, 95% CI: 0.18–0.79). For those who were prescribed antibiotics, the incidence of AAD was 0.57 episodes per resident year (95% CI: 0.41–0.81 episodes). AAD was more likely in residents who were prescribed co-amoxiclav (hazards ratio, HR = 2.08, 95% confidence interval, CI: 1.18–3.66) or routinely used incontinence pads (HR = 2.54, 95% CI: 1.26–5.13) and less likely in residents from residential homes (HR compared with nursing homes: 0.14, 95% CI: 0.06–0.32).Conclusion: residents of care homes, particularly of nursing homes, are frequently prescribed antibiotics and often experience diarrhoea following such prescriptions. Co-amoxiclav is associated with greater risk of AAD.
Keywords: antibiotic prescribing, antibiotic-associated diarrhoea, care home residents, Clostridium difficile, older people
College: College of Human and Health Sciences