Projects per year
Abstract
Background
Antibiotic misuse is a key contributor to antimicrobial resistance and a concern in long-term aged care facilities (LTCFs). Our objectives were to: i) summarise key indicators of systemic antibiotic use and appropriateness of use, and ii) examine temporal and regional variations in antibiotic use, in LTCFs (PROSPERO registration CRD42018107125).
Methods & findings
Medline and EMBASE were searched for studies published between 1990–2021 reporting antibiotic use rates in LTCFs. Random effects meta-analysis provided pooled estimates of antibiotic use rates (percentage of residents on an antibiotic on a single day [point prevalence] and over 12 months [period prevalence]; percentage of appropriate prescriptions). Meta-regression examined associations between antibiotic use, year of measurement and region. A total of 90 articles representing 78 studies from 39 countries with data between 1985–2019 were included. Pooled estimates of point prevalence and 12-month period prevalence were 5.2% (95% CI: 3.3–7.9; n = 523,171) and 62.0% (95% CI: 54.0–69.3; n = 946,127), respectively. Point prevalence varied significantly between regions (Q = 224.1, df = 7, p<0.001), and ranged from 2.4% (95% CI: 1.9–2.7) in Eastern Europe to 9.0% in the British Isles (95% CI: 7.6–10.5) and Northern Europe (95% CI: 7.7–10.5). Twelve-month period prevalence varied significantly between regions (Q = 15.1, df = 3, p = 0.002) and ranged from 53.9% (95% CI: 48.3–59.4) in the British Isles to 68.3% (95% CI: 63.6–72.7) in Australia. Meta-regression found no association between year of measurement and antibiotic use prevalence. The pooled estimate of the percentage of appropriate antibiotic prescriptions was 28.5% (95% CI: 10.3–58.0; n = 17,245) as assessed by the McGeer criteria. Year of measurement was associated with decreasing appropriateness of antibiotic use over time (OR:0.78, 95% CI: 0.67–0.91). The most frequently used antibiotic classes were penicillins (n = 44 studies), cephalosporins (n = 36), sulphonamides/trimethoprim (n = 31), and quinolones (n = 28).
Conclusions
Coordinated efforts focusing on LTCFs are required to address antibiotic misuse in LTCFs. Our analysis provides overall baseline and regional estimates for future monitoring of antibiotic use in LTCFs.
Original language | English |
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Article number | e0256501 |
Pages (from-to) | 1-24 |
Number of pages | 24 |
Journal | PLoS ONE |
Volume | 16 |
Issue number | 8 |
DOIs | |
Publication status | Published - Aug 2021 |
Bibliographical note
Copyright the Author(s) 2021. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.Fingerprint
Dive into the research topics of 'Temporal and regional trends of antibiotic use in long-term aged care facilities across 39 countries, 1985-2019: systematic review and meta-analysis'. Together they form a unique fingerprint.Projects
- 1 Active
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Optimising eHealth systems to improve medication safety and patient outcomes
1/01/18 → …
Project: Research
Press/Media
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Seven in ten residents receive antibiotics: study
Magda Raban, Peter Gates & Johanna Westbrook
16/09/21
1 Media contribution
Press/Media: Research
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Antibiotic use in Australian aged care ‘too high’
Magda Raban, Peter Gates & Johanna Westbrook
2/09/21
1 item of Media coverage
Press/Media: Research
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’Time is running out’ on antibiotic misuse, experts say
Magda Raban, Peter Gates & Johanna Westbrook
26/08/21
1 Media contribution
Press/Media: Research