USA Today and Fox News both reported the dangers of overusing antibiotics in nursing homes. Antibiotics are prescribed incorrectly to ailing nursing home residents up to 75% of the time, the nation’s public health watchdog says. The CDC last month advised all nursing homes to do more – immediately – to protect more than 4 million residents from hard-to-treat superbugs that are growing in number and resist antibiotics.
Health officials and health-care executives, concerned by a rise in dangerous drug-resistant infections, are turning more attention to nursing homes, where antibiotics are some of the most frequently prescribed medications. Up to 70 percent of nursing home residents receive one or more courses of antibiotics every year for urinary tract infections, pneumonia, cellulitis and other suspected conditions, according to researchers. Yet up to 75 percent of those prescriptions are given incorrectly—either unnecessarily or the prescription is for the wrong drug, dose or duration, the Centers for Disease Control and Prevention says.
The reasons vary — wrong drug, wrong dose, wrong duration or just unnecessarily – but the consequences are scary, warns the Centers for Disease Control and Prevention. Overused antibiotics over time lose their effectiveness against the infections they were designed to treat. And some antibiotics actually cause life-threatening illnesses on their own. One of the biggest culprits, researchers say: misdiagnosed urinary tract infections. Only a quarter to a third of people in nursing homes who are diagnosed have actual symptoms, according to several studies. Most have only vague symptoms like confusion or bacteria in their urine that aren’t actually causing an infection, says David Nace, director of long-term care and flu programs at the University of Pittsburgh. UTIs are “the poster child of inappropriate antibiotic use,” he says.
Antibiotic-resistant infections threaten everyone, but elderly people in nursing homes are especially at risk because their bodies don’t fight infections as well. The CDC counts 18 top antibiotic-resistant infections that sicken more than 2 million people a year and kill 23,000. Those infections contribute to deaths in many more cases.
The CDC is launching a public education campaign for nursing homes aimed at preventing more bacterial and viral infections from starting and stopping others from spreading. A similar effort was rolled out for hospitals last year. “One way to keep older Americans safe from these superbugs is to make sure antibiotics are used appropriately all the time and everywhere, particularly in nursing homes,” said CDC Director Tom Frieden in announcing the initiative.
Here’s why that worries the CDC: Every time someone takes antibiotics, sensitive bacteria are killed but resistant bacteria survive and multiply – and they can spread to other people. Repeated use of antibiotics promotes the growth of antibiotic-resistant bacteria. Taking antibiotics for illnesses the drugs weren’t made to treat – such as flu and common colds – contributes to antibiotic resistance.
Antibiotics also wipe out a body’s good infection-fighting bacteria along with the bad. When that occurs, infections like Clostridium difficile can get out of control. C. diff. leads to serious diarrhea that each year puts 250,000 people in the hospital and kills 15,000. If precautions aren’t taken, it can spread in hospitals and nursing homes.
In addition to fostering antibiotic resistant bacteria and causing C. diff infections, antibiotics also can produce allergic reactions and interfere with other drugs a nursing home resident is taking. Those risks aren’t always fully considered, says researcher Christopher Crnich, who has published articles on antibiotic overuse. He is a hospital epidemiologist at William S. Middleton Veterans Hospital in Madison, Wis.