Heudorf Ursel, Stalla Kristin
Institute for Hygiene and Environmental Medicine, Justus-Liebig University, Giessen, Germany.
Vivantes Forum for Seniors GmbH, Berlin, Germany.
GMS Hyg Infect Control. 2024 Apr 17;19:Doc17. doi: 10.3205/dgkh000472. eCollection 2024.
In Germany, hospitals, rehabilitation facilities and outpatient surgery facilities are required by law to perform antibiotic-consumption surveillance. Established IT programs are available for recording the defined daily doses. These do not exist for long-term care facilities (LTCFs). Antibiotic stewardship is also recommended for LTCFs. In view of the lack of IT solutions for consumption surveillance, this study investigated whether point prevalence studies could be a suitable basis for a data-based antibiotic stewardship program in LTCFs.
In May 2023, 18 elderly-care facilities in Berlin, Germany, participated in a point prevalence survey on antibiotic consumption according to the established HALT (healthcare-associated infections in long-term care facilities) method. The number of residents present and their risk factors (including the use of catheters and antibiotic therapy) were recorded. The results were compared with comparable data from previous surveys in LTCFs in Berlin, Germany as well as with the HALT data for Europe as a whole and for Germany.
On the day of the survey, 2040 residents were present, 7.7% of whom bore a urinary catheter and 0.5% a vascular catheter. 0.2% of the residents had a port access, 0.4% a dialysis catheter and one resident (0.05%) a tracheostoma. Twenty-seven (1.3%) residents were receiving an antibiotic on the day of the survey. Of these, 29.6% had a urinary tract catheter. 63.0% of the antibiotics were given for a urinary tract infection, 14.8% for a respiratory tract infection and 11.1% for a wound/soft tissue infection. The overall prevalence of antibiotics was in the range of previous surveys from Germany (1.2-2.4%) and significantly lower than in the Europe-wide HALT survey overall (4.3-4.5%).
The survey showed low use of antibiotics in the LTCFs in comparison with Europe-wide surveys. The time required was less than 2 hours for a 100-bed facility. Until appropriate IT programs to determine the defined daily doses are also available for LTCFs, such easy-to-perform and standardized point-prevalence surveys - if repeated several times a year - can be a suitable method for recording the use of antibiotics in nursing homes for the elderly.
在德国，法律要求医院、康复机构和门诊手术机构开展抗生素使用监测。已有成熟的信息技术程序用于记录限定日剂量。但长期护理机构（LTCF）尚无此类程序。长期护理机构也建议实施抗生素管理。鉴于缺乏用于使用监测的信息技术解决方案，本研究调查了现患率研究是否可为长期护理机构基于数据的抗生素管理计划提供合适的依据。
2023年5月，德国柏林的18家老年护理机构按照既定的HALT（长期护理机构中的医疗相关感染）方法参与了抗生素使用现患率调查。记录在场居民的数量及其危险因素（包括导管使用情况和抗生素治疗情况）。将结果与德国柏林长期护理机构以往调查的可比数据以及整个欧洲和德国的HALT数据进行比较。
调查当天，共有2040名居民在场，其中7.7%携带导尿管，0.5%携带血管导管。0.2%的居民有端口接入装置，0.4%有透析导管，1名居民（0.05%）有气管造口。27名（1.3%）居民在调查当天正在接受抗生素治疗。其中，29.6%有尿道导管。63.0%的抗生素用于治疗尿路感染，14.8%用于治疗呼吸道感染，11.1%用于治疗伤口/软组织感染。抗生素的总体使用率处于德国以往调查的范围（1.
