Residential aged care homes in Australia are at risk of becoming into a "reservoir" of drug-resistant bacteria due to the misuse of antibiotics, researchers say.
Dr David Kong, Dr Anton Peleg and coauthors studied four Melbourne residential
aged care facilities (RACFs) and found that 37% of suspected infections that
were treated with antibiotics did not fulfil the criteria for clinical
They also found that only 36% of suspected infections treated
with antibiotics had documentation that clinical specimens were obtained to
confirm the diagnosis, in some cases contrary to national Antibiotic
The authors wrote that the inappropriate use of antibiotics
in some instances in this setting "may result in the RACFs becoming a reservoir
for multiresistant organisms" but that these findings also reflected the
difficulties in clinically assessing this patient population.
"Routine ordering of microbiological tests is not always practical
in the RACF setting. This reflects the difficulties in obtaining specimens, the
involvement of multiple laboratories servicing these institutions and the lack
of timely results that inform prescribing", the authors wrote.
In addition to difficulties in clinical diagnosis, the lack
of clinical cultures also hindered the monitoring of antibiotic resistance
trends among this population.
"Accordingly, alternative approaches such as periodic
surveillance of antimicrobial resistance patterns may be more feasible in this
setting", they wrote. This approach was taken in recent work by Dr Rhonda
Stuart and colleagues.