Murray MT, et al. - This study was performed with the aim to delineate antibiotic use in three paediatric long term care (LTC) facilities and to describe the factors associated with use. Use of antibiotics in paediatric LTC facilities is widespread. As per findings, researchers recommended further assessment of antibiotic use in paediatric LTC. They identified evaluation of the adverse outcomes associated with inappropriate antibiotic use including the prevalence of resistant organisms in paediatric LTC facilities as crucial.

Methods

• In three paediatric LTC facilities, from September 2012 to December 2015, a retrospective cohort study was conducted.
• For demographics, healthcare-associated infections (HAI), antimicrobial use, and diagnostic testing, medical records were reviewed.
• To identify predictors for antibiotic use, logistic regression was used.
• Chi square was used to assess the association between susceptibility testing results and appropriate antibiotic coverage.

Results

• At least one HAI was present in 58% (413/717) of residents.
• Of these, 79% were treated with at least one antibiotic course, totalling 2.75 antibiotic courses per 1000 resident-days.
• Significant association of receiving antibiotics was observed with length of enrolment greater than one year, having a neurologic disorder, having a tracheostomy, and being hospitalised at least once during the study, when controlling for facility (all p < 0.001).
• For 40% of antibiotic-treated HAI, diagnostic testing was performed.
• Appropriate coverage was observed in 86% of antibiotic courses for identified bacterial pathogens (n=201/233).
• Findings suggested no association of having access to susceptibility testing with appropriate antibiotic choice. (p=0.26).