Higher Antibiotic Use Among Younger Home Care Patients

Those younger than 65 years and with poor health more likely to receive antibiotics

THURSDAY, June 23 (HealthDay News) -- Home care patients younger than 65 years and those with poor health are more likely to receive antibiotic treatment, according to a study published in the July issue of Infection Control and Hospital Epidemiology.

Dominik Mertz, M.D., from McMaster University in Hamilton, Canada, and colleagues investigated the prevalence and risk factors of antibiotic use among 126,339 patients receiving home care services for more than 60 days. Experienced nurses collected data from all available information sources, including assessor observation, patient and family self-report, and other medical records. All drugs the patients had received in the seven days prior to the assessment were recorded.

The investigators found that 6,873 (5.4 percent) of home care patients received antibiotic treatment. Fluoroquinolones were the most commonly prescribed antibiotics (26 percent). Patients age 65 years and older had a significantly lower likelihood of antibiotic treatment. Although some comorbidities were correlated with antibiotic use, overall, the sum of comorbidities did not affect antibiotic use. Factors that were significantly associated with increased antibiotic use in both univariate and multivariate analysis included having an indwelling urinary catheter, being HIV-positive, having peripheral vascular disease, and having active skin ulcers or a history of resolved skin ulcers.

"In conclusion, 5.4 percent of home care patients received antibiotic treatment, and fluoroquinolones were the most frequently prescribed antibiotics. The likelihood of receiving antibiotic treatment was highest in patients less than 65 years of age and among those with a poorer health status, suggesting that overuse of antibiotics might be most prevalent in these subgroups of patients," the authors write.

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