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Temporal and regional trends of antibiotic use in long-term aged care facilities across 39 countries, 1985-2019: Systematic review and meta-analysis

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  • Magdalena Z Raban
  • Peter J Gates
  • Claudia Gasparini
  • Johanna I Westbrook

Abstract

Background: Antibiotic misuse is a key contributor to antimicrobial resistance and a concern in long-term aged care facilities (LTCFs). Our objectives were to: i) summarise key indicators of systemic antibiotic use and appropriateness of use, and ii) examine temporal and regional variations in antibiotic use, in LTCFs (PROSPERO registration CRD42018107125). Methods & findings: Medline and EMBASE were searched for studies published between 1990–2021 reporting antibiotic use rates in LTCFs. Random effects meta-analysis provided pooled estimates of antibiotic use rates (percentage of residents on an antibiotic on a single day [point prevalence] and over 12 months [period prevalence]; percentage of appropriate prescriptions). Meta-regression examined associations between antibiotic use, year of measurement and region. A total of 90 articles representing 78 studies from 39 countries with data between 1985–2019 were included. Pooled estimates of point prevalence and 12-month period prevalence were 5.2% (95% CI: 3.3–7.9; n = 523,171) and 62.0% (95% CI: 54.0–69.3; n = 946,127), respectively. Point prevalence varied significantly between regions (Q = 224.1, df = 7, p

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  • Magdalena Z Raban & Peter J Gates & Claudia Gasparini & Johanna I Westbrook, 2021. "Temporal and regional trends of antibiotic use in long-term aged care facilities across 39 countries, 1985-2019: Systematic review and meta-analysis," PLOS ONE, Public Library of Science, vol. 16(8), pages 1-24, August.
    • Handle: RePEc:plo:pone00:0256501
    DOI: 10.1371/journal.pone.0256501
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    Cited by:

    1. Hall, Julie & Hawkins, Olivia & Montgomery, Amy & Singh, Saniya & Mullan, Judy & Degeling, Chris, 2022. "Dismantling antibiotic infrastructures in residential aged care: The invisible work of antimicrobial stewardship (AMS)," Social Science & Medicine, Elsevier, vol. 305(C).
    2. Manuela Casula & Ilaria Ardoino & Carlotta Franchi, 2023. "Appropriateness of the Prescription and Use of Medicines: An Old Concept but More Relevant than Ever," IJERPH, MDPI, vol. 20(3), pages 1-5, February.

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