Challenges in Balancing Antibiotic Stewardship, Individual Resident Needs

​A study of antibiotic prescription for suspected urinary tract infections (UTIs) in four nursing homes, published online November 23, 2012, by BMC Geriatrics, found that half of the prescriptions were written for asymptomatic residents, raising concerns about ongoing antibiotic stewardship. Moreover, the study found that 80% of antibiotic prescriptions written for residents with indwelling catheters were written in the absence of UTI signs or symptoms, although they usually were written with urinalysis results available. Given the frequency of urinalysis result availability, the authors state that diagnostic testing likely plays a major role in the decision to prescribe antibiotics for UTI and that more study is warranted in how physicians use this data in their prescription decision. Physicians in this case are faced with balancing short- and long-term risks, the authors state.