AHRQ Program Helped Long-Term Care Facilities Reduce Antibiotic Use

Researchers from Johns Hopkins Medicine and NORC at the University of Chicago found that the Agency for Healthcare Research and Quality's (AHRQ) Safety Program for Improving Antibiotic Use is effective in helping long-term care providers ensure that patients receive the appropriate dosage of their antibiotic medication.

The AHRQ program is a system to help providers implement antibiotic stewardship programs. It includes 15 webinars that discuss strategies for operating an antibiotic stewardship program within a long-term care facility (LTC), the importance of teamwork, and how to treat infections with appropriate levels of antibiotics. The webinars are repeated three times over a year.

Like the absence of antibiotics, excessive amounts can lead to the emergence of bacterial strains and Clostridioides difficile, a pathogen causing diarrhea and colitis. Further, patients with infections can become resistant to antibiotics.

Researchers from Johns Hopkins Medicine and NORC at the University of Chicago decided to study the AHRQ Safety Program for Improving Antibiotic Use and determine its efficacy at helping providers reduce unnecessary antibiotic use in LTCs.

“It can be incredibly challenging to implement effective stewardship programs in the long-term care setting because of high staff turnover rates and limited resources; however, it’s very important for the older adults living there who can have severe side effects if given unnecessary antibiotics,” said study lead author Morgan Katz, MD, assistant professor of medicine at the Johns Hopkins University School of Medicine, in the news release. “Reframing antibiotic use as a patient safety issue and incorporating direct care staff in the prescribing process can make these programs more sustainable.” 

Of the 523 LTCs that began the AHRQ program, 439 completed it.

The 439 LTCs that completed the program noticed positive results following year. There was a noted decrease in antibiotic treatment courses and the amount of orally prescribed antibiotics per 1,000 resident days.  

“Particularly worth noting was our finding that improvements in antibiotic use were more pronounced in LTCs with greater engagement in the ASP [antibiotic stewardship programs], suggesting that for antibiotic stewardship, those who do the work get the results,” said Katz.

Though researchers said that more data is needed to gauge a better understanding of antibiotic stewardship, they concluded that the AHRQ program could help LTCs effectively maintain patient safety.

As research progresses regarding way to improve the administration of antibiotics, telehealth is emerging as a potential tool.

A study from 2020 showed how pediatricians using a telehealth platform that included clinical decision support tools helped them prescribe a more accurate dosage of antibiotics. Published in the Journal of General Internal Medicine, the study concluded that this led to fewer antibiotic-resistant infections.