What is Antibiotic Stewardship?

Authors: Morgan Harris & Karen Jones

Antibiotic Stewardship

Antibiotic stewardship programs in nursing homes will help decrease the risk to older adults caused by the overuse of antibiotics. The main goal of antibiotic stewardship is to improve how antibiotics are being prescribed by clinicians and how they are being used by the patients.


Chilling facts about antibiotics:

·  75% of nursing home residents receive one or more courses of antibiotics within a year

·  40-75% of prescribed antibiotics in nursing homes are unnecessary.

·  40% of deaths among those 65+ were from antibiotic-resistant infections

·  Overall, 2.8 million antibiotic-resistant infections were reported in 2019 which lead to 35,000 deaths

Antibiotic resistance is a growing challenge that every healthcare personnel in long-term care facilities faces.

Five Rights of Using Antibiotics

The “Five Rights” of antibiotic use will help increase the quality of life of the older patients seeking care. They will help decrease toxicity, allergic reactions, and sepsis in patients.

“The Five Rights”
Core elements of antibiotic stewardship

The most important way to get all the health care personnel on your unit to practice the antibiotic stewardship program is to educate them on it! Nursing home staff and prescribers should learn about symptoms and different diagnostic tests available, instead of just going straight to prescribing antibiotics. Flyers, pocket-guides, and newsletters can be made to help keep staff practicing good stewardship. Family members and residents should also be educated on antibiotic stewardship. Overall, make the education portion of the program fun and entertaining for the best results.

Proper Antibiotic Prescribing Techniques

·  Shorter is Smarter

o   Short course antibiotic therapy (five to seven days) has similar outcomes to a ten-day duration for uncomplicated cystitis, pneumonia, and cellulitis.

·  Loeb’s Minimum Criteria

o    Loeb’s minimum criteria is used to initiate antibiotic therapy safely and efficiently. The criteria are broken up by symptom and then the minimum requirements for the patient to start antibiotic therapy.

CDC Core Elements

The CDC outline seven key elements of antibiotic stewardship that all employees in the facility should abide by. These seven points are as follows and can be reviewed on the CDC website:

CDC Core Elements