Antimicrobial Agent Use for Urinary Tract Infection in Long-Term Care Facilities in Spain: Results from a Retrospective Analytical Cohort Analysis

Author:

Matovelle Priscila12ORCID,Olivan-Blázquez Bárbara345ORCID,Magallón-Botaya Rosa346,García-Sangenís Ana789ORCID,Monfà Ramon78ORCID,Morros Rosa789,Navarro Sanmartín Alicia10,Mateos-Nozal Jesús11ORCID,Sáez Bejar Carmen1213,Rodríguez Jiménez Consuelo14,López Pérez Elena15,Llor Carl791516

Affiliation:

1. Geriatrics Department, Hospital San Juan de Dios, 50006 Zaragoza, Spain

2. Geriatrics Department, Universidad de Zaragoza, 50009 Zaragoza, Spain

3. Group B21-23R, Health Research Institute of Aragon (IISA), 50009 Zaragoza, Spain

4. Network for Research on Chronicity, Primary Care and Health Promotion (RICAPPS, RD21/0016/0005), 50015 Zaragoza, Spain

5. Department of Psychology and Sociology, University of Zaragoza, 50009 Zaragoza, Spain

6. Medicine Department, Universidad de Zaragoza, 50009 Zaragoza, Spain

7. Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina, 08007 Barcelona, Spain

8. Pharmacology Department, Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), 08193 Bellaterra, Spain

9. CIBER en Enfermedades Infecciosas Instituto Carlos III, 28029 Madrid, Spain

10. Nursing Home, Aragon Institute of Social Services (IASS), 50540 Borja, Spain

11. Geriatrics Department, Hospital Universitario Ramón y Cajal (IRYCIS), 28034 Madrid, Spain

12. Internal Medicine Department, Hospital Universitario La Princesa, Instituto de Investigación Sanitaria (IIS-Princesa), 28006 Madrid, Spain

13. Research Institute of Princesa (IIS Princesa), 28006 Madrid, Spain

14. Pharmacology Department, Complejo Hospitalario Universitario de Canarias, 38320 Santa Cruz de Tenerife, Spain

15. Institut Català de la Salut, 08038 Barcelona, Spain

16. Research Unit for General Practice, Department of Public Health, University of Southern Denmark, 5230 Odense, Denmark

Abstract

Urinary tract infections (UTIs) are highly prevalent in long-term care facilities, constituting the most common infection in this setting. Our research focuses on analyzing clinical characteristics and antimicrobial prescriptions for UTIs in residents across nursing homes (NH) in Spain. This is a retrospective analytical cohort analysis using a multifaceted approach based on the normalization process theory to improve healthcare quality provided by nursing staff in 34 NHs in Spain. In this study, we present the results of the first audit including 719 UTI cases collected between February and April 2023, with an average age of 85.5 years and 74.5% being women. Cystitis and pyelonephritis presented distinct symptom patterns. Notably, 6% of asymptomatic bacteriuria cases were treated. The prevalence of dipstick usage was 83%, and that of urine culture was only 16%, raising concerns about overreliance, including in the 46 asymptomatic cases, leading to potential overdiagnosis and antibiotic overtreatment. Improved diagnostic criteria and personalized strategies are crucial for UTI management in NHs, emphasizing the need for personalized guidelines on the management of UTIs to mitigate indiscriminate antibiotic use in asymptomatic cases.

Funder

Pfizer Inc. managed by Global Medical Grants & Global Bridges Mayo Clinic Quality Improvement

Publisher

MDPI AG

Reference45 articles.

1. European Union (EU) Eurostat (2023). Eurostat—Population Projections 2023 Based, Eurostat. Population Projections in the EU—Statistics Explained.

2. Infection Control in Long Term Care Institutions for the Elderly: A Reflection Document on the Situation in Spain;Bouza;Rev. Esp. Quimioter.,2023

3. Antibiotic Use and Infections in Nursing Homes;Alberg;Tidsskr. Nor. Laegeforen.,2017

4. Healthcare-Associated Infection in Irish Long-Term Care Facilities: Results from the First National Prevalence Study;Cotter;J. Hosp. Infect.,2012

5. Abizanda Soler, P., and Rodríguez Mañas, L. (2015). Tratado de Medicina Geriátrica: Fundamentos de La Atención Sanitaria a Los Mayores, Elsevier.

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