Journal of General Internal Medicine

, Volume 16, Issue 6, pp 376–383 | Cite as

Antibiotic use in ontario facilities that provide chronic care

  • Mark Loeb
  • Andrew E. Simor
  • Lisa Landry
  • Stephen Walter
  • Margaret McArthur
  • JoAnn Duffy
  • Debora Kwan
  • Allison McGeer
Original Articles


OBJECTIVE: To determine the incidence and variability of antibiotic use in facilities which provide chronic care and to determine how often clinical criteria for infection are met when antibiotics are prescribed in these facilities.

DESIGN: A prospective, 12-month, observational cohort study.

SETTING: Twenty-two facilities which provide chronic care in southwestern Ontario.

PARTICIPANTS: Patients who were treated with systemic antibiotics over the study period.

MEASUREMENTS: Characteristics of antibiotic prescriptions (name, dose, duration, and indication) and clinical features of randomly selected patients who were treated with antibiotics.

RESULTS: A total of 9,373 courses of antibiotics were prescribed for 2,408 patients (66% of the patients in study facilities). The incidence of antibiotic prescriptions in the facilities ranged from 2.9 to 13.9 antibiotic courses per 1,000 patient-days. Thirty-six percent of antibiotics were prescribed for respiratory tract infections, 33% for urinary infections, and 13% for skin and soft tissue infections. Standardized surveillance definitions of infection were met in 49% of the 1,602 randomly selected patients who were prescribed antibiotics. Diagnostic criteria for respiratory, urinary, and skin infection were met in 58%, 28%, and 65% of prescriptions, respectively. One third of antibiotic prescriptions for a urinary indication were for asymptomatic bacteriuria. Adverse reactions were noted in 6% of prescriptions for respiratory and urinary infections and 4% of prescriptions for skin infection.

CONCLUSIONS: Antibiotic use is frequent and highly variable amongst patients who receive chronic care. Reducing antibiotic prescriptions for asymptomatic bacteriuria represents an important way to optimize antibiotic use in this population.

Key words

antibiotic use chronic care facilities infection 


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Copyright information

© Blackwell Science Inc 2001

Authors and Affiliations

  • Mark Loeb
    • 1
    • 2
  • Andrew E. Simor
    • 4
  • Lisa Landry
    • 3
    • 4
  • Stephen Walter
    • 2
  • Margaret McArthur
    • 3
    • 4
  • JoAnn Duffy
    • 5
  • Debora Kwan
    • 5
  • Allison McGeer
    • 3
    • 4
  1. 1.Received from the Division of Microbiology, Departments of PathologyMcMaster UniversityHamiltonCanada
  2. 2.Clinical Epidemiology and BiostatisticsMcMaster UniversityHamiltonCanada
  3. 3.Department of Microbiology and Infection ControlMount Sinai and Princess Margaret HospitalsCanada
  4. 4.Department of Microbiology, Sunnybrook and Women’s College Health Sciences CentreUniversity of TorontoTorontoCanada
  5. 5.Departments of Infection Control and PharmacyQueen Elizabeth HospitalTorontoCanada

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