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New Program Lowers Antibiotic Use and Improves Patient Safety in Long-Term Care Facilities

NORC Article

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April 2022

Overuse of antibiotics can lead to drug-resistant bacteria and harm to patients. This problem is particularly acute in long-term care settings (LTCs) such as nursing homes and assisted living facilities, where some 1.7 million older adults in the United States reside. To address these concerns, the Agency for Healthcare Research and Quality (AHRQ) funded Johns Hopkins Medicine and NORC to design, implement, and assess the AHRQ Safety Program for Improving Antibiotic Use in Long Term Care. The implementation approach included 15 training webinars on how to establish and maintain a stewardship program, ways to improve teamwork and communication, best practices for diagnosing and managing common infectious syndromes, as well as access to experts in antimicrobial stewardship, infectious disease and implementation approaches, and several tools to promote stewardship activities.

“While more data are needed to gauge the long-term effects and sustainability of the AHRQ Safety Program for Improving Antibiotic Use in Long Term Care, our findings hold promise for helping such facilities equip their frontline staff with the necessary knowledge and skills to improve antibiotic prescribing and patient safety.” 

Prashila Dullabh

Director, Health Implementation Science Center

“While more data are needed to gauge the long-term effects and sustainability of the AHRQ Safety Program for Improving Antibiotic Use in Long Term Care, our findings hold promise for helping such facilities equip their frontline staff with the necessary knowledge and skills to improve antibiotic prescribing and patient safety.” 

They found that the vast majority of participating facilities—439 of 523—completed the year-long program, a surprisingly high number given LTCs’ limited resources and frequent staff turnover. Program completion led to significant decreases in the number of antibiotic treatment courses and urine cultures in these LTCs. Facilities that were more engaged in the webinars and other program activities had higher success rates.




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