Antibiotic prescribing in 4 assisted-living communities: incidence and potential for improvement (original) (raw)

To describe the prevalence, characteristics, and appropriateness of systemic antibiotic use in assisted living (AL) and to conduct a preliminary quality improvement intervention trial to reduce inappropriate prescribing. Pre-post study, with a 13-month intervention period. Four AL communities. All prescribers, all AL staff who communicate with prescribers, and all patients who had an infection during the baseline and intervention periods. A standardized form for AL staff, an online education course and 5 practice briefs for prescribers, and monthly quality improvement meetings with AL staff. Monthly inventory of all systemic antibiotic prescriptions; interviews with the prescriber, AL staff member, closest family member, and patient (when capable) regarding 85 antibiotic prescribing episodes (30 baseline, 55 intervention), with data review by an expert panel to determine prescribing appropriateness. The mean number of systemic antibiotic prescriptions was 3.44 per 1,000 resident-day...