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Antibiotic Overuse in Nursing Homes

Antibiotics are among the most-prescribed medications in American nursing homes, with up to 70% of residents receiving at least one course of these drugs every year, most unnecessarily. Our team of nursing home negligence lawyers takes a look into antibiotic overuse and how it is affecting resident health.

The largest driver of this overuse is urinary tract infections (UTIs), which account for between 30% and 56% of inappropriate antibiotics. Many residents given antibiotics for UTIs do not have any symptoms beyond having bacteria in their urine, which does not always indicate infection. Other common ailments driving antibiotic overuse include pneumonia and cellulitis.

We are just now beginning to understand the immense danger of antibiotic overuse. The rise of drug-resistant germs and the inability of standard drugs to treat infections are two major problems associated with overuse. It is a major reason why infections are rising dramatically within nursing homes. Unnecessary antibiotics also lead to immediate adverse events, such as Clostridium difficile, diarrhea or gastroenteritis, and allergic reactions. Clostridium difficile, or C.diff, is common in nursing homes and can be deadly for those over the age of 65.

Bacterium becomes resistant to drugs when it has encountered them so many times that it changes to either protect it from or neutralize the drug. Bacteria that survive drugs then multiply, passing on resistant properties to other bacteria. Doctors, facilities, and residents themselves all have a role in ensuring proper drug use in nursing homes.

When to Treat and When Not to Treat

The most important thing to remember is that antibiotics only treat bacterial infections, not viral infections. Strep throat, for example, is a bacterial infection, while bronchitis and most sore throats are viruses. Other common viral infections that do not benefit from antibiotics include: cold, some ear infections, some sinus infections, and the flu.

Antibiotic overuse persists in nursing homes for many reasons. Doctors may prescribe antibiotics before receiving full test results; residents may want fast relief from symptoms; staff or residents may fail to take antibiotics as prescribed, leading to the need to resume treatment. Residents may also have cognitive issues like dementia, which makes it difficult for them to explain their symptoms. Much of the medical decision-making for residents is done over the phone, so doctors likely do not physically examine patients before prescribing.

In the United States at least two million people suffer serious infections from drug-resistant bacteria every year. At least 23,000 people die each year die from these infections. Along with the previously mentioned adverse events, drug-resistant infections also result in:

  • Increased risk of fall (more on this below)
  • Advanced illness or disability
  • More invasive treatments
  • Prolonged recovery
  • More deaths

It is important to note that studies have found that antibiotic-related events occur even among residents who do not take antibiotics. One study found that one in eight residents experienced an adverse event related to antibiotic prescribing, regardless of whether they personally took the drugs.

Infections Increase Fall Risk

Researchers at Massachusetts General Hospital recently conducted a study that found infections may be a precursor to many falls that occur in nursing homes and hospitals. Although many infections have subtle symptoms, both the falls and the infection can be very serious. Falls often lead to fractured bones, head injuries, and other life-threatening injuries.

Symptoms related to altered mental functioning, such as confusion, or weakness may indicate an infection is present. Identifying this allows staff to be more proactive about preventing falls, which are a major problem in nursing homes. Falls are often blamed on obstacles or environmental factors, but this study shows that infections may also be a significant cause.

Our team of nursing home lawyers has been fighting on behalf of nursing home residents for 30 years. We help residents injured by falls, bedsores, wrongful or over-medication, elopement, and other forms of abuse and neglect. We accept cases nationwide, and always provide free legal consultations for residents or concerned family members.