AUTHOR=Kagansky Nadya , Rosenberg Reena , Derazne Estela , Mazurez Evelina , Levy Yochai , Barchana Micha 

TITLE=Implementation of a program for treatment of acute infections in nursing homes without hospital transfer

JOURNAL=Frontiers in Medicine

VOLUME=Volume 11 - 2024

YEAR=2024

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2024.1333523

DOI=10.3389/fmed.2024.1333523

ISSN=2296-858X

ABSTRACT=Background: Nursing care residents have high hospitalization rates. To address this, we established a unique virtual geriatric unit that has developed a program aimed at providing support to nursing homes.
Aims: We aimed to evaluate effectiveness of in-house intravenous antibiotic treatment in nursing hospitals after the implementation of the specially designed training program.   
Methods: A cohort study of nursing home residents to evaluate a training program for providers, designed to increase awareness and give practical tools for in-house treatment of acute infections. Data obtained included types of infections, antibiotics used, hospital transfer, length of treatment. Primary outcomes were in-house recovery, hospitalization and mortality.  Univariate analysis and multivariable logistic regression analysis to assess association between different factors and recovery. 
Results: A total of 890 cases of acute infections were treated with intravenous antibiotics across 10 nursing homes over a total of 4,436 days. Of these cases, 34.8% were aged 90 years or older. Acute pneumonia was the most prevalent infection accounted for 354 cases (40.6%), followed by urinary tract infections (35.7%), and fever of presumed bacterial infection (17.1%).
The mean duration of intravenous antibiotic treatment was 5.09± 3.86 days. Of the total cases, 800 (91.8%) recovered, 62 (7.1%) required hospitalization and nine (1.0%) resulted in mortality. There was no significant difference observed in recovery rates across different types of infections.
Discussion: Appling a simple yet unique intervention program has led to more "in-house" residents receiving treatment, with positive clinical results.