Some seniors getting antibiotics for too long; doctor preference may trump need

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TORONTO - A new study suggests many seniors living in long-term care facilities could and probably should be put on shorter courses of antibiotics when they have bacterial infections.

The study says nearly half of antibiotic prescriptions written for Ontario seniors in long-term care in 2010 were for a treatment course of longer than seven days.

The authors suggest most infections can be treated more quickly than that and the excess time on antibiotics should be reduced.

The researchers found that the problem seems to be one of habit; some doctors repeatedly default to longer courses of treatment.

They say that if all doctors adopted the habits of those who treat with short courses of antibiotics, the overall number of days seniors are taking antibiotics in long-term care could drop by as much as 19 per cent.

The study is being published in the journal JAMA Internal Medicine.

The issue is one of safety, both for the individual seniors and for society as a whole.

Taking antibiotics for longer than needed increases a senior's risk of developing C. difficile diarrhea and of contracting an infection caused by an antibiotic resistant bacterium.

It also contributes to the development of antibiotic resistant superbugs in general.

Dr. Nick Daneman, the first author of the paper, says cutting back on overall use of antibiotics is a challenge, but fine-tuning the length of time people are taking the drugs provides an opportunity to make some inroads.

"Shortening that tail end of treatment, at which point antibiotics are putting people at potential risk without any potential benefit, seems to be a real feasible way to reduce antibiotic overuse,'' he says.

Daneman is an adjunct scientist at Toronto's Institute for Clinical Evaluative Sciences, and an infectious diseases specialist.

Organizations: Institute for Clinical Evaluative Sciences

Geographic location: TORONTO, Ontario

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