University of Nottingham, Nottingham, UK.
Boots UK Ltd, Thane Road, Nottingham, UK.
J Antimicrob Chemother. 2019 Jul 1;74(7):2083-2090. doi: 10.1093/jac/dkz135.
The majority of people in long-term care facilities (LTCFs) are aged 65 years and older, and most of their care needs are provided by the LTCF staff. Provision of healthcare services for residents in LTCFs is variable and can result in disjointed care between carers and NHS healthcare professionals.
Our aim was to understand the use of antibiotics in LTCFs across the UK and to identify potential gaps in knowledge and support for carers and residents when using antibiotics, in order to determine how community pharmacy teams can provide additional support.
A point prevalence survey (PPS) was conducted by community pharmacists (n = 57) when they carried out visits to LTCFs across the UK between 13 November and 12 December 2017. Anonymized data were recorded electronically by the individual pharmacists.
Data were analysed for 17909 residents in 644 LTCFs across the UK. The mean proportion of residents on antibiotics on the day of the visit was as follows: 6.3% England (536 LTCFs), 7.6% Northern Ireland (35 LTCFs), 8.6% Wales (10 LTCFs) and 9.6% Scotland (63 LTCFs). The percentage of antibiotics prescribed for prophylactic use was 25.3%. Antibiotic-related training was reported as being available for staff in 6.8% of LTCFs and 7.1% of LTCFs reported use of a catheter passport scheme. Pharmacists conducting the PPS intervened during the survey for 9.5% of antibiotic prescription events; 53.4% of interventions were for clinical reasons and 32.2% were for administration reasons.
This survey identified high prophylactic use of antibiotics. There are opportunities for community pharmacy teams to improve antimicrobial stewardship in LTCF settings, including workforce education.
长期护理机构（LTCF）中的大多数人年龄在 65 岁及以上，他们的大部分护理需求由 LTCF 工作人员提供。LTCF 为居民提供的医疗服务各不相同，可能导致护理人员和 NHs 医疗保健专业人员之间护理脱节。
我们的目的是了解英国各地 LTCF 中抗生素的使用情况，并确定护理人员和居民在使用抗生素时在知识和支持方面可能存在的差距，以便确定社区药剂师团队如何提供额外的支持。
社区药剂师（n = 57）于 2017 年 11 月 13 日至 12 月 12 日期间在英国各地的 LTCF 进行访问时进行了点患病率调查（PPS）。个别药剂师以电子方式记录匿名数据。
对英国各地 644 家 LTCF 中的 17909 名居民进行了数据分析。访问当天使用抗生素的居民比例如下：英格兰 6.3%（536 家 LTCF），北爱尔兰 7.6%（35 家 LTCF），威尔士 8.6%（10 家 LTCF）和苏格兰 9.6%（63 家 LTCF）。预防性使用抗生素的处方比例为 25.3%。报告称，有 6.8%的 LTCF 为工作人员提供抗生素相关培训，有 7.1%的 LTCF 报告使用了导尿管护照计划。进行 PPS 的药剂师在调查期间对 9.5%的抗生素处方事件进行了干预；53.4%的干预是出于临床原因，32.2%是出于管理原因。
这项调查发现抗生素的预防性使用很高。社区药剂师团队有机会改善 LTCF 环境中的抗菌药物管理，包括员工教育。
