Resources for Antimicrobial Stewardship Programs in Long-Term Care

Antibiotic overuse is contributing to increasing rates of antimicrobial resistance. Research shows that 50% of antibiotic courses in long-term care (LTC) are not needed and residents in homes with higher antibiotic use experience a 24% increased risk of antibiotic-related harm.

Public Health Ontario (PHO) has developed two suites of resources to address the overuse of antibiotics in long-term care homes (LTCHs):

1. Shorter is Smarter resources focus on the evidence to support shorter courses of antibiotic treatment for long-term care (LTC) residents.
2. Antimicrobial Stewardship Essentials resources aim to help guide LTCHs interested in developing an antimicrobial stewardship program. 

We spoke to Bradley Langford, Acting Lead of PHO’s Antimicrobial Stewardship Program and Rita Ha, Pharmacist Consultant, to learn more about these resources.*

What motivated you to develop these resources? 

We discovered a knowledge gap in regards to antimicrobial stewardship in LTC through consultations, surveys and interviews with LTC prescribers and staff. There was an identified need to provide evidence for why shorter courses of antibiotics can be effective and safe for residents of LTCHs. LTC clinicians and staff could also benefit from a framework for implementing antimicrobial stewardship initiatives in LTC, taking into account the unique needs and resources of this setting. 

How did you develop these resources?

PHO conducted literature searches on the duration of therapy for common infections in LTC and drew from key references and systematic reviews on antimicrobial stewardship in LTC. The Shorter Is Smarter resources were reviewed by infectious disease physicians, as well as LTC prescribers and pharmacists. We consulted an LTC nurse practitioner, pharmacists and nurses who would be key members in an ASP in LTC for the Antimicrobial Stewardship Essentials.

How will these resources help those in the long-term sector?

The Shorter is Smarter resources attempt to address the knowledge gap and misconception that LTC residents need longer durations of therapy to adequately treat infections and prevent antibiotic resistance. The Antimicrobial Stewardship Essentials attempt to help LTC stakeholders by integrating recommended ASP components and evidence-based strategies in a familiar and practical quality improvement (QI) framework to encourage behaviour change in the home. Solutions and program development will be unique to each LTCH depending on available resources.

Visit the Antimicrobial Stewardship page for more information and resources. 

*This interview has been edited and condensed for clarity.