It is an established fact that any antibiotic use contributes to the development of antibiotic resistance. In elderly care homes, urinary tract infections (UTI) are common. To treat these infections, antibiotics are used, with most prescriptions being inappropriate. There are many factors that influence the prescription practices of the doctor. Dependence on the nonspecific behavioural symptoms of the elderly as signs of UTI is one such factor. Secondly, in elderly, presence of bacteria in urine without infection is common, termed as asymptomatic bacteriuria. Both these situations do not require antibiotic prescription. But most of the antibiotic prescriptions are being done in these situations. As a result, the antibiotic use in elderly people is contributing to an increase in the antibiotic resistance. To counteract this antibiotic overuse, the Danish care homes implemented a complex intervention.
The intervention consisted of an interactive educational session and two tools to be used by the care home staff- one for observation and reflection and second one for communicating with the general practitioner. These tools helped the staff to deliver clinically relevant information to the doctor. During the interactive educational session, the staff were trained on UTI, assessing the non-specific symptoms, difference between UTI and asymptomatic bacteriuria.
The intervention was well accepted by the care home staff. It was an eyeopener to them to learn that one can have bacteria in urine without any infection. The intervention led to “unlearning and de-implementing” the existing practices.
To know more about the intervention, the barriers and challenges in implementing the intervention, kindly visit the website of the journal BMC Geriatrics (Link).