Antibiotic Resistance
Posted By Chris on June 6, 2010
In 2004, the Centers for Disease Control (CDC) developed a 12 steps campaign to prevent antimicrobial resistance in long-term care. Step # 4 states “Broad-spectrum antibiotics must be targeted to known pathogens.” Broad spectrum antibiotics are frequently ordered in long-term care. The physician is usually not on the premises when they receive a call that a patient has a complaint of burning when they urinate, they seem more confused than usual, or any number of vague complaints. The physician may not even know the patient; they may be on call for another physician. Are these symptoms, as reported, relative to a true change in condition? Is the physician getting an accurate picture of what is going on with the patient? When the physician does not have a clear picture of what might be going on, the broad spectrum antibiotic is a tempting choice to make; It may be prophylactic but it treats multiple organisms and buys time until labs are ordered, drawn and resulted. But, misuse of Broad Spectrum Antibiotics has also caused the resistance that is now actually limiting a physician’s choice for treatment.
Communication from nursing staff to physician could be one of the most important steps toward preventing the misuse of antibiotics. Treatment of suspected infections must be supported by accurately reporting pertinent data gathered by nurses experienced in using established surveillance tools. McGeer’s Definitions of Infection is the resource most commonly used for surveillance in long-term care. Nurses need encouragement and education to develop familiarity with established criteria and strong nursing observation skills.
Thank you for your comments, I really appreciate it. Are you working in Long-term Care?
CW