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Development of Minimum Criteria for the Initiation of Antibiotics in Residents of Long-Term–Care Facilities: Results of a Consensus Conference

Published online by Cambridge University Press:  02 January 2015

Mark Loeb*
Affiliation:
Division of Infectious Diseases and Medical Microbiology, McMaster University and Hamilton Civic Hospitals, Hamilton, Ontario, Canada
David W. Bentley
Affiliation:
Department of Internal Medicine, Saint Louis University School of Medicine, Geriatric Research, Education and Clinical Center, St Louis Veterans Affairs (VA) Medical Center, St Louis, Missouri
Suzanne Bradley
Affiliation:
VA Medical Center GRECC, Ann Arbor, Michigan
Kent Crossley
Affiliation:
Education Service, VA Medical Center, Minneapolis, Minnesota
Richard Garibaldi
Affiliation:
Department of Medicine, University of Connecticut Health Center, Farmington, Connecticut
Nelson Gantz
Affiliation:
Department of Medicine, Polyclinic Medical Center, Harrisburg, Pennsylvania
Allison McGeer
Affiliation:
Department of Infection Control, Mount Sinai Hospital and theUniversity of Toronto, Toronto, Ontario, Canada
Robert R. Muder
Affiliation:
VA Pittsburgh Healthcare System, University of Pittsburgh Medical Center, Pennsylvania
Joseph Mylotte
Affiliation:
Erie County Medical Center, Buffalo, New York
Lindsay E. Nicolle
Affiliation:
Department of Medicine, Health Sciences Center, University of Manitoba, Winnipeg, Manitoba, Canada
Brenda Nurse
Affiliation:
Hospital for Special Care, New Britain, Connecticut
Shirley Paton
Affiliation:
Laboratory Centre for Disease Prevention and Control, Health Canada, Ottawa, Ontario, Canada
Andrew E. Simor
Affiliation:
Sunnybrook and Women's College Health Sciences Center and theUniversity of Toronto, Toronto, Ontario, Canada
Philip Smith
Affiliation:
University of Nebraska Medical Center, Omaha, Nebraska
Larry Strausbaugh
Affiliation:
Portland VA Medical Center, Portland, Oregon
*
Hamilton Health Sciences Corp, Henderson General Hospital Site, 711 Concession St, Hamilton, ON L8V 1C3, Canada

Abstract

Establishing a clinical diagnosis of infection in residents of long-term–care facilities (LTCFs) is difficult. As a result, deciding when to initiate antibiotics can be particularly challenging. This article describes the establishment of minimum criteria for the initiation of antibiotics in residents of LTCFs. Experts in this area were invited to participate in a consensus conference. Using a modified delphi approach, a questionnaire and selected relevant articles were sent to participants who were asked to rank individual signs and symptoms with respect to their relative importance. Using the results of the weighting by participants, a modification of the nominal group process was used to achieve consensus. Criteria for initiating antibiotics for skin and soft-tissue infections, respiratory infections, urinary infections, and fever where the focus of infection is unknown were developed.

Type
Topics in Long-Term Care
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2001

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