Antibiotic use is common in long-term care facilities (LTCF) with 70% residents receiving at least one course of systemic antibiotic every year. A significant proportion of the antibiotic use (40% to 75%) in nursing homes has been found to be unnecessary or inappropriate. Antibiotic exposure drives selection for multi-drug resistant organisms and C difficile infection. Antibiotic stewardship promotes appropriate antibiotic use and is important in combating antibiotic resistant bacteria. Centers for Medicare and Medicaid Services (CMS) will require all long-term care (LTC) facilities to have an antibiotic stewardship program by November 28, 2017 as part of the requirements for participation.
Most long-term care facilities do not have any experience in implementing antibiotic stewardship program and these facilities also lack expertise in this area. Under the leadership of Dr. Robin Jump, Infection Advisory Committee of AMDA – The society for post-acute and long-term care medicine has developed a template for antibiotic stewardship policy for post-acute and long-term care settings. Dr. Muhammad Salman Ashraf, an associate professor in the division of infectious diseases at UNMC, who is also a member of the infection advisory committee of AMDA, has also contributed in the development of this template. This template is published in November issue of JAMDA (The Journal of Post-Acute and Long-Term Care Medicine) and can be found at http://www.jamda.com/article/S1525-8610(17)30430-9/fulltext
According to Dr. Ashraf, long-term care facilities can adapt antibiotic stewardship policy mentioned in this template to meet the requirements of CMS. The template also provide some guidance on implementation of antibiotic stewardship program. Another helpful part of this document is a compiled list of many free resources that can be used for development of an antibiotic stewardship program.
Dr. Ashraf, who is also the co-medical director of Nebraska ASAP (Antimicrobial Stewardship Assessment and Promotion Program), pointed out that in addition to the resources mentioned in this document, long-term care facilities can also found some other helpful tools on Nebraska ASAP website (https://asap.nebraskamed.com) which was launched after this template was already submitted to the journal. Long-term care facilities in Nebraska should feel free to contact Nebraska ASAP with any question regarding development of antibiotic stewardship program and the ASAP team will make every effort to provide the best guidance.
Content courtesy of Dr. Ashraf.