(91) Use of Antibiotics for Urinary Tract Infections Up to and After Nursing Home Admission in Denmark

Saturday, August 27, 2022

8:00 AM – 6:00 PM CEST

Location: Hall C

Publication Number: 765

Presenting Author(s)

Emma Bjørk, MScPharm
– PhD student, Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense, Syddanmark, Denmark

Co-Author(s)

Rune Aabenhus
– Section of General Practice and Research Unit for General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark, Denmark
Søren Larsen
– REAGENS, Skaarup Fyn, Denmark, Denmark
Jesper Ryg
– Department of Geriatric Medicine, Odense University Hospital, Odense C, Denmark, Denmark
Daniel Pilsgaard Henriksen
– MD PhD., University of Southern Denmark, Department of Clinical Research, University of Southern Denmark, Odense C, Syddanmark, Denmark
Carina Lundby
– Research Unit, Hospital Pharmacy Funen, Odense University Hospital, Odense C, Denmark, Denmark
Anton Pottegård, PhD, MSc
– University of Southern Denmark, Odense C, Denmark

Background: Use of antibiotics for acute and chronic urinary tract infection (UTI) is high among residents in long-term care facilities, despite diagnostic uncertainty and the growing problem of antibiotic resistance.

Objectives: To describe use patterns of UTI-antibiotics and UTI-related hospital admissions up to and after nursing home admission in Denmark.

Methods: In a cohort of all Danish residents moving into nursing homes in 2015-2020, supplied with data from the nationwide Danish health care registries, we described prescription patterns, use of UTI-antibiotics (pivmecillinam, nitrofurantoin, sulfonamides, trimethoprim, ciprofloxacin), and hospital admissions related to UTIs in the two years preceding and following nursing home admission. Further, we examined differences in UTI-antibiotic use across the Danish regions, municipalities, and individual nursing homes.

Results: The cohort comprised 86,214 residents (61% female; median age 84 years). The most commonly used UTI-antibiotic were pivmecillinam (54%) and trimethoprim (18%). Fifteen percent of all UTI prescriptions was followed by another UTI prescription within 15 days. General practicioners prescribed the majoritiy (86%) of all UTI-antibiotics. UTI antibiotic use doubled prior to nursing home admission from 7 to 14 treatments per 100 residents per month two months prior to admission. Following admission, UTI antibiotic use dropped to 10 treatments per 100 resident per months consistently over the following two years. Overall, women used slightly more UTI antibiotics compared to men, e.g. 15 vs 11 in the month prior to admission. Hospital admissions related to UTIs peaked at three months prior to moving in, with 3 admissions per 100 residents, dropping to 1 admission per 100 residents per month subsequently. We found considerable variation in use of UTI-antibiotics between nursing homes, with ten percent of nursing homes responsible for one third of all UTI treatments in 2020.

Conclusions: Use of UTI antibiotics increased prior to and remained at a stable high level during the two-year follow-up after nursing home admission. Most prescriptions were prescribed by general practitioners. Use of UTI-antibiotics showed considerable variation between individual nursing homes.