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Antibiotic prescribing and associated diarrhoea: a prospective cohort study of care home residents

D. Gillespie, K. Hood, A. Bayer, B. Carter, D. Duncan, A. Espinasse, M. Evans, J. Nuttall, H. Stanton, A. Acharjya, S. Allen, D. Cohen, S. Groves, N. Francis, R. Howe, A. Johansen, E. Mantzourani, E. Thomas-Jones, A. Toghill, F. Wood, N. Wigglesworth, M. Wootton, C. C. Butler, Samantha Groves

Age and Ageing

Swansea University Author: Samantha Groves

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DOI (Published version): 10.1093/ageing/afv072

Abstract

Background: the risk factors for and frequency of antibiotic prescription and antibiotic-associated diarrhoea (AAD) among care home residents are unknown.Aim: to prospectively study frequency and risks for antibiotic prescribing and AAD for care home residents.Design and setting: a 12-month prospect...

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Published in: Age and Ageing
Published: 2015
Online Access: http://ageing.oxfordjournals.org/content/early/2015/06/22/ageing.afv072.abstract?keytype=ref&ijkey=XtzcfskPbQ9U5WY
URI: https://cronfa.swan.ac.uk/Record/cronfa22177
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fullrecord <?xml version="1.0"?><rfc1807><datestamp>2015-06-26T12:19:28.0881749</datestamp><bib-version>v2</bib-version><id>22177</id><entry>2015-06-26</entry><title>Antibiotic prescribing and associated diarrhoea: a prospective cohort study of care home residents</title><swanseaauthors><author><sid>eb642e3823a000ee7550db9c062c2cdb</sid><ORCID/><firstname>Samantha</firstname><surname>Groves</surname><name>Samantha Groves</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2015-06-26</date><deptcode>HHE</deptcode><abstract>Background: the risk factors for and frequency of antibiotic prescription and antibiotic-associated diarrhoea (AAD) among care home residents are unknown.Aim: to prospectively study frequency and risks for antibiotic prescribing and AAD for care home residents.Design and setting: a 12-month prospective cohort study in care homes across South Wales.Method: antibiotic prescriptions and the development of AAD were recorded on case report forms. We defined AAD as three or more loose stools in a 24-h period occurring within 8 weeks of exposure to an antibiotic.Results: we recruited 279 residents from 10 care homes. The incidence of antibiotic prescriptions was 2.16 prescriptions per resident year (95% CI: 1.90&#x2013;2.46). Antibiotics were less likely to be prescribed to residents from dual-registered homes (OR compared with nursing homes: 0.38, 95% CI: 0.18&#x2013;0.79). For those who were prescribed antibiotics, the incidence of AAD was 0.57 episodes per resident year (95% CI: 0.41&#x2013;0.81 episodes). AAD was more likely in residents who were prescribed co-amoxiclav (hazards ratio, HR = 2.08, 95% confidence interval, CI: 1.18&#x2013;3.66) or routinely used incontinence pads (HR = 2.54, 95% CI: 1.26&#x2013;5.13) and less likely in residents from residential homes (HR compared with nursing homes: 0.14, 95% CI: 0.06&#x2013;0.32).Conclusion: residents of care homes, particularly of nursing homes, are frequently prescribed antibiotics and often experience diarrhoea following such prescriptions. Co-amoxiclav is associated with greater risk of AAD.</abstract><type>Journal Article</type><journal>Age and Ageing</journal><publisher/><keywords>antibiotic prescribing, antibiotic-associated diarrhoea, care home residents, Clostridium difficile, older people</keywords><publishedDay>31</publishedDay><publishedMonth>12</publishedMonth><publishedYear>2015</publishedYear><publishedDate>2015-12-31</publishedDate><doi>10.1093/ageing/afv072</doi><url>http://ageing.oxfordjournals.org/content/early/2015/06/22/ageing.afv072.abstract?keytype=ref&amp;amp;ijkey=XtzcfskPbQ9U5WY</url><notes/><college>COLLEGE NANME</college><department>Swansea Centre for Health Economics</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>HHE</DepartmentCode><institution>Swansea University</institution><apcterm/><lastEdited>2015-06-26T12:19:28.0881749</lastEdited><Created>2015-06-26T12:10:22.6930788</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">School of Health and Social Care</level></path><authors><author><firstname>D.</firstname><surname>Gillespie</surname><order>1</order></author><author><firstname>K.</firstname><surname>Hood</surname><order>2</order></author><author><firstname>A.</firstname><surname>Bayer</surname><order>3</order></author><author><firstname>B.</firstname><surname>Carter</surname><order>4</order></author><author><firstname>D.</firstname><surname>Duncan</surname><order>5</order></author><author><firstname>A.</firstname><surname>Espinasse</surname><order>6</order></author><author><firstname>M.</firstname><surname>Evans</surname><order>7</order></author><author><firstname>J.</firstname><surname>Nuttall</surname><order>8</order></author><author><firstname>H.</firstname><surname>Stanton</surname><order>9</order></author><author><firstname>A.</firstname><surname>Acharjya</surname><order>10</order></author><author><firstname>S.</firstname><surname>Allen</surname><order>11</order></author><author><firstname>D.</firstname><surname>Cohen</surname><order>12</order></author><author><firstname>S.</firstname><surname>Groves</surname><order>13</order></author><author><firstname>N.</firstname><surname>Francis</surname><order>14</order></author><author><firstname>R.</firstname><surname>Howe</surname><order>15</order></author><author><firstname>A.</firstname><surname>Johansen</surname><order>16</order></author><author><firstname>E.</firstname><surname>Mantzourani</surname><order>17</order></author><author><firstname>E.</firstname><surname>Thomas-Jones</surname><order>18</order></author><author><firstname>A.</firstname><surname>Toghill</surname><order>19</order></author><author><firstname>F.</firstname><surname>Wood</surname><order>20</order></author><author><firstname>N.</firstname><surname>Wigglesworth</surname><order>21</order></author><author><firstname>M.</firstname><surname>Wootton</surname><order>22</order></author><author><firstname>C. C.</firstname><surname>Butler</surname><order>23</order></author><author><firstname>Samantha</firstname><surname>Groves</surname><orcid/><order>24</order></author></authors><documents/><OutputDurs/></rfc1807>
spelling 2015-06-26T12:19:28.0881749 v2 22177 2015-06-26 Antibiotic prescribing and associated diarrhoea: a prospective cohort study of care home residents eb642e3823a000ee7550db9c062c2cdb Samantha Groves Samantha Groves true false 2015-06-26 HHE Background: the risk factors for and frequency of antibiotic prescription and antibiotic-associated diarrhoea (AAD) among care home residents are unknown.Aim: to prospectively study frequency and risks for antibiotic prescribing and AAD for care home residents.Design and setting: a 12-month prospective cohort study in care homes across South Wales.Method: antibiotic prescriptions and the development of AAD were recorded on case report forms. We defined AAD as three or more loose stools in a 24-h period occurring within 8 weeks of exposure to an antibiotic.Results: we recruited 279 residents from 10 care homes. The incidence of antibiotic prescriptions was 2.16 prescriptions per resident year (95% CI: 1.90–2.46). Antibiotics were less likely to be prescribed to residents from dual-registered homes (OR compared with nursing homes: 0.38, 95% CI: 0.18–0.79). For those who were prescribed antibiotics, the incidence of AAD was 0.57 episodes per resident year (95% CI: 0.41–0.81 episodes). AAD was more likely in residents who were prescribed co-amoxiclav (hazards ratio, HR = 2.08, 95% confidence interval, CI: 1.18–3.66) or routinely used incontinence pads (HR = 2.54, 95% CI: 1.26–5.13) and less likely in residents from residential homes (HR compared with nursing homes: 0.14, 95% CI: 0.06–0.32).Conclusion: residents of care homes, particularly of nursing homes, are frequently prescribed antibiotics and often experience diarrhoea following such prescriptions. Co-amoxiclav is associated with greater risk of AAD. Journal Article Age and Ageing antibiotic prescribing, antibiotic-associated diarrhoea, care home residents, Clostridium difficile, older people 31 12 2015 2015-12-31 10.1093/ageing/afv072 http://ageing.oxfordjournals.org/content/early/2015/06/22/ageing.afv072.abstract?keytype=ref&amp;ijkey=XtzcfskPbQ9U5WY COLLEGE NANME Swansea Centre for Health Economics COLLEGE CODE HHE Swansea University 2015-06-26T12:19:28.0881749 2015-06-26T12:10:22.6930788 Faculty of Medicine, Health and Life Sciences School of Health and Social Care D. Gillespie 1 K. Hood 2 A. Bayer 3 B. Carter 4 D. Duncan 5 A. Espinasse 6 M. Evans 7 J. Nuttall 8 H. Stanton 9 A. Acharjya 10 S. Allen 11 D. Cohen 12 S. Groves 13 N. Francis 14 R. Howe 15 A. Johansen 16 E. Mantzourani 17 E. Thomas-Jones 18 A. Toghill 19 F. Wood 20 N. Wigglesworth 21 M. Wootton 22 C. C. Butler 23 Samantha Groves 24
title Antibiotic prescribing and associated diarrhoea: a prospective cohort study of care home residents
spellingShingle Antibiotic prescribing and associated diarrhoea: a prospective cohort study of care home residents
Samantha Groves
title_short Antibiotic prescribing and associated diarrhoea: a prospective cohort study of care home residents
title_full Antibiotic prescribing and associated diarrhoea: a prospective cohort study of care home residents
title_fullStr Antibiotic prescribing and associated diarrhoea: a prospective cohort study of care home residents
title_full_unstemmed Antibiotic prescribing and associated diarrhoea: a prospective cohort study of care home residents
title_sort Antibiotic prescribing and associated diarrhoea: a prospective cohort study of care home residents
author_id_str_mv eb642e3823a000ee7550db9c062c2cdb
author_id_fullname_str_mv eb642e3823a000ee7550db9c062c2cdb_***_Samantha Groves
author Samantha Groves
author2 D. Gillespie
K. Hood
A. Bayer
B. Carter
D. Duncan
A. Espinasse
M. Evans
J. Nuttall
H. Stanton
A. Acharjya
S. Allen
D. Cohen
S. Groves
N. Francis
R. Howe
A. Johansen
E. Mantzourani
E. Thomas-Jones
A. Toghill
F. Wood
N. Wigglesworth
M. Wootton
C. C. Butler
Samantha Groves
format Journal article
container_title Age and Ageing
publishDate 2015
institution Swansea University
doi_str_mv 10.1093/ageing/afv072
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str School of Health and Social Care{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}School of Health and Social Care
url http://ageing.oxfordjournals.org/content/early/2015/06/22/ageing.afv072.abstract?keytype=ref&amp;ijkey=XtzcfskPbQ9U5WY
document_store_str 0
active_str 0
description Background: the risk factors for and frequency of antibiotic prescription and antibiotic-associated diarrhoea (AAD) among care home residents are unknown.Aim: to prospectively study frequency and risks for antibiotic prescribing and AAD for care home residents.Design and setting: a 12-month prospective cohort study in care homes across South Wales.Method: antibiotic prescriptions and the development of AAD were recorded on case report forms. We defined AAD as three or more loose stools in a 24-h period occurring within 8 weeks of exposure to an antibiotic.Results: we recruited 279 residents from 10 care homes. The incidence of antibiotic prescriptions was 2.16 prescriptions per resident year (95% CI: 1.90–2.46). Antibiotics were less likely to be prescribed to residents from dual-registered homes (OR compared with nursing homes: 0.38, 95% CI: 0.18–0.79). For those who were prescribed antibiotics, the incidence of AAD was 0.57 episodes per resident year (95% CI: 0.41–0.81 episodes). AAD was more likely in residents who were prescribed co-amoxiclav (hazards ratio, HR = 2.08, 95% confidence interval, CI: 1.18–3.66) or routinely used incontinence pads (HR = 2.54, 95% CI: 1.26–5.13) and less likely in residents from residential homes (HR compared with nursing homes: 0.14, 95% CI: 0.06–0.32).Conclusion: residents of care homes, particularly of nursing homes, are frequently prescribed antibiotics and often experience diarrhoea following such prescriptions. Co-amoxiclav is associated with greater risk of AAD.
published_date 2015-12-31T03:26:24Z
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score 11.014067

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