• Age and ageing · Sep 2015

    Multicenter Study Comparative Study

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

    • David Gillespie, Kerenza Hood, Antony Bayer, Ben Carter, Donna Duncan, Aude Espinasse, Meirion Evans, Jacqueline Nuttall, Helen Stanton, Arun Acharjya, Stephen Allen, David Cohen, Sam Groves, Nick Francis, Robin Howe, Antony Johansen, Efi Mantzourani, Emma Thomas-Jones, Alun Toghill, Fiona Wood, Neil Wigglesworth, Mandy Wootton, and Christopher C Butler.
    • South East Wales Trials Unit, School of Medicine, Cardiff University, Cardiff, UK.
    • Age Ageing. 2015 Sep 1; 44 (5): 853-60.

    Backgroundthe risk factors for and frequency of antibiotic prescription and antibiotic-associated diarrhoea (AAD) among care home residents are unknown.Aimto prospectively study frequency and risks for antibiotic prescribing and AAD for care home residents.Design And Settinga 12-month prospective cohort study in care homes across South Wales.Methodantibiotic 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.Resultswe 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).Conclusionresidents 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.© The Author 2015. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

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