More than two-thirds (66.8%) of UK long-term care facilities (LTCFs) surveyed by visiting community pharmacists had at least one resident on antibiotics, with high prophylactic use of antibiotics for urinary tract infections (UTI), according to a new study in the Journal of Antimicrobial Chemotherapy.
A point prevalence survey (PPS) was conducted by community pharmacists (n=57) when they carried out visits to 644 LTCFs across the UK between 13 November and 12 December 2017. Data were analysed for 17,909 residents.
The mean proportion of residents on antibiotics on the day of the visit was: 6.3% England (536 LTCFs), 7.6% Northern Ireland (35 LTCFs), 8.6% Wales (10 LTCFs), and 9.6% Scotland (63 LTCFs).
Amoxicillin, nitrofurantoin, and trimethoprim accounted for half (n=622) of the antibiotics.
The proportion of residents on antibiotics was higher in nursing homes (7.7%) compared with residential homes (6.7%).
Over a third of the prescribed antibiotics (38.7%) were for UTIs and, of these, almost half (47.1%) were for prophylactic use. Just under a third of antibiotics (31.6%) were for respiratory tract infections, the majority of which were to treat infections (93.4%).
Missed antibiotic doses were recorded for 9.2% of residents (n=115), with refusal by the patient being the most common reason (47.0%).
The majority of antibiotics were prescribed by a GP visiting the LTCF in person.
Pharmacists conducting the PPS intervened for 9.5% of the antibiotic prescription events; 53.4% of interventions were for clinical reasons and 32.2% were for administration reasons.
Antibiotic-related training was reported as being available for staff in only 6.8% of LTCFs.
Whilst these results only provide a snapshot in time of antibiotic use within LTCFs, they are the largest data set published to date across the UK, in particular for England, which has been under-represented in previous surveys, said the study authors.