CDC: Up to 3 in 4 SNF antibiotics drug orders wrong

Too many prescriptions are either unnecessarily issued, or for the wrong dose or duration, researchers say.
Too many prescriptions are either unnecessarily issued, or for the wrong dose or duration, researchers say.

[Editor's Note: This article has been modified from its original version to clarify the figures cited by the Centers for Disease Control and Prevention.]

Up to 75% of antibiotics prescriptions given to nursing home residents are unnecessary or incorrectly prescribed, the Centers for Disease Control and Prevention claims.

A new report from the Wall Street Journal cites CDC statistics indicating a majority of nursing home residents receive one or more courses of antibiotics each year to treat common conditions such as urinary tract infections, pneumonia and cellulitis. But up to 75% of those prescriptions are either unnecessarily prescribed, or for the wrong drug, dose or duration.

One of the most common causes of inappropriately prescribed antibiotics is misdiagnosed urinary tract infections — “the poster child of inappropriate antibiotic use,” David Nace, director of long-term care and flu programs at the University of Pittsburgh, told the Wall Street Journal.

Only a quarter to a third of nursing home residents diagnosed with a UTI symptoms that meet the clinical definitions for the infection, researchers claim. Most cases are diagnosed based on symptoms such as confusion or bacteria in urine, which don't always signal a UTI.

The push to curb antibiotic overuse in nursing homes is a “tall order” due to factors including high staff turnover, antibiotics prescribed by clinicians who haven't seen the patients and patients with dementia who can't accurately describe their symptoms, according to the Wall Street Journal report.

Last month the CDC released antibiotic guidelines for nursing homes, to guide prescribing practices and help reduce the harmful effects of antibiotic resistant infections such as C. difficile.