Misuse of Antibiotics in Long-term Care Facilities Leads to Increasing Amounts of Antibiotic Resistant Bacteria

The Journal of the American Medical Director’s Association has just published a literature survey looking at the overuse of antibiotics and spread of resistant bacteria strains in long-term healthcare institutions. The authors have sifted through 156 scholarly reports on the subject to come up with a synthesized statement on long-term care and antibiotic resistance. They have also focused on prevention measures, both against the creation of new resistant strains and the spread of infections throughout facilities. These observations are particularly relevant to skilled nursing facilities as the elderly are at an increased risk for severe infections due to more compromised immune systems and other care factors.

The use of antibiotics in long-term care has a very high prevalence. On average, 47 to 79% of all patients are one some kind of antibiotic, for a wide array of health reasons. While these drugs are a vital tool in healthcare, not all use is warranted or correct. The overuse and misuse of antibiotics can result in bacterial super-strains, that are resistant to all or most of known antibiotics and generally have a higher rate of morbidity and mortality. Perhaps the most well-known of these strains is methicillin-resistant Staphylococcus aureus, or as it is more commonly known: MRSA. Other resistant infections include strains of pneumonia, strep, meningitis, and many cases of sepsis. The numbers of resistant infections have gone up greatly over the last decade. In order to break this trend, training about the misuse of antibiotics has to be stressed, especially in places like nursing homes where prescription rates are very high. The study also identifies the failure to implement infection control procedures as an issue in nursing facilities, putting patients at risk. Only 38.1% of all nursing homes employ an infection control officer.

The misuse of medication can be a problem in skilled nursing facilities. Many institutions do not employ the necessary numbers of nursing staff to see to all of the needs of each resident individually. In such long-term care facilities many patients require assistance in normal function and activities. But instead of devoting the staffing hours necessary to supervise the patients to prevent falls and accidents, some places will instead prescribe antipsychotic drugs and tranquilizers to subdue and restrain them. Off-label prescribing to chemically control patients is frequently employed in conjunction with excessive use of physical restraints. The use of medications as restraints is not only dangerous as many of the drugs can have very harmful side-effects, but it is also a direct violation of patients’ rights.

By law, nursing care facilities are required to provide adequate staff to supervise and assist in daily activities for those patients that need it, and the use of medications instead of direct care contact is abuse. California Health and Safety Code section 1430(b) allows any patient that has been subject to injury and abuse to sue the offending facility for damages. Other abuses that can prompt a 1430(b) case include dehydration, malnutrition, pressure ulcers, and the improper treatment of incontinence issues.


If you believe that your loved one is suffering from the misuse of prescription medications or any other symptom of elder abuse, please contact us. We want to help ensure that your loved is free from harm and gets the quality of care that he or she deserves.