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Antibiotic prescribing and associated diarrhoea: a prospective cohort study of care home residents

Gillespie, David ORCID:, Hood, Kerenza ORCID:, Bayer, Antony James ORCID:, Carter, Ben Richard, Duncan, D., Espinasse, Aude, Evans, Meirion Rhys ORCID:, Nuttall, Jacqueline, Stanton, Helen, Acharjya, A., Allen, S., Cohen, D., Groves, S., Francis, Nicholas Andrew ORCID:, Howe, R., Johansen, A., Mantzourani, Efthymia D. ORCID:, Thomas-Jones, Emma ORCID:, Toghill, A., Wood, Fiona ORCID:, Wigglesworth, Neil, Wootton, Mandy and Butler, Christopher Collet ORCID: 2015. Antibiotic prescribing and associated diarrhoea: a prospective cohort study of care home residents. Age and Ageing 44 (5) , pp. 853-860. 10.1093/ageing/afv072

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Background: the risk factors for and frequency of antibiotic prescription and antibiotic-associated diarrhoea (AAD) among care home residents are unknown. Aim: to prospectively study frequency and risks for antibiotic prescribing and AAD for care home residents. Design and setting: a 12-month prospective cohort study in care homes across South Wales. Method: antibiotic prescriptions and the development of AAD were recorded on case report forms. We defined AAD as three or more loose stools in a 24-h period occurring within 8 weeks of exposure to an antibiotic. Results: we recruited 279 residents from 10 care homes. The incidence of antibiotic prescriptions was 2.16 prescriptions per resident year (95% CI: 1.90–2.46). Antibiotics were less likely to be prescribed to residents from dual-registered homes (OR compared with nursing homes: 0.38, 95% CI: 0.18–0.79). For those who were prescribed antibiotics, the incidence of AAD was 0.57 episodes per resident year (95% CI: 0.41–0.81 episodes). AAD was more likely in residents who were prescribed co-amoxiclav (hazards ratio, HR = 2.08, 95% confidence interval, CI: 1.18–3.66) or routinely used incontinence pads (HR = 2.54, 95% CI: 1.26–5.13) and less likely in residents from residential homes (HR compared with nursing homes: 0.14, 95% CI: 0.06–0.32). Conclusion: residents of care homes, particularly of nursing homes, are frequently prescribed antibiotics and often experience diarrhoea following such prescriptions. Co-amoxiclav is associated with greater risk of AAD.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Biosciences
Systems Immunity Research Institute (SIURI)
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
R Medicine > RM Therapeutics. Pharmacology
Publisher: Oxford University Press
ISSN: 0002-0729
Date of First Compliant Deposit: 30 March 2016
Date of Acceptance: 7 June 2015
Last Modified: 20 Jun 2024 18:10

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