From: Antimicrobial stewardship in residential aged care facilities: need and readiness assessment
Themes | Positive views | Negative views |
---|---|---|
Perceptions of current antibiotic prescribing behaviour | Q1. “It [Antibiotic use] is probably about right, I’ve sort of never had an issue where I’ve thought ‘oh no they should have been on antibiotics or yeah they should not be’, and as I said a lot of our [residents], you’ve got to weigh up the [change of] behaviours and the risks to everyone.” (NUM 13, 30 yr) | Q4. “I guess the other thing is that we know particularly in the elderly, it’s better to get in early and treat. So if you think should I/shouldn’t I, then treat, you know, rather than wait until they get crook. And if it’s a bit of over treatment so be it.” (GP 7, 30 yr) |
Q2. “It’s usually pretty reasonable. Because bearing in mind that where it may be a viral infection initially, a lot of these people are frail, non-ambulant and will go on to a secondary bacterial infection.” (Consultant pharmacist 5, 12 yr) | Q5. “Probably an over use, because we get pressured by nursing staff mostly to prescribe, they're very reluctant to let anyone with a cold be untreated.” (GP 1, 32 yr) | |
Q3. “We don’t have the luxury of if this antibiotic doesn’t work we’ll try something else, often they [RACF residents] can go down so fast…You don’t have that second chance, so you’ve really got to hit them [with broader spectrum antibiotics].” (GP 13, 30 yr) | Q6. “It’s increased for everything; someone sneezes they get antibiotics, somebody’s urine smells or you know it lights up a stick, they get antibiotics.” (NUM14, 12 yr) | |
Q7. “… some GPs continually use the same antibiotics, you know people are put on the same antibiotics for maybe 2 months….they don’t think to go and check to see if they're resistant or whatever any more.” (NUM 7, 9 yr) | ||
Q8. “Well, there might be an infection, they just go in there and write up a broad-spectrum [antibiotic] and have it for 2 weeks regardless of what the infection is. They're not too much adhering to the [Australian national] antibiotic guidelines.” (Community pharmacist 1, 7 yr) | ||
Perceptions of antibiotic resistance | Q9. “I wouldn’t say there's been any change [of antibiotic resistance trend] in all the time I’ve practiced medicine…Probably I don’t do that much pathological testing, but I don’t see it as having been an issue.” (GP 12, 5 yr) | Q11. “I would think so, yes, I think you get more of the really unusual urine reports and unusual bacteria or ones with multi resistance, yeah for sure…I guess anywhere where there's a lot of antibiotic use there's going to be a lot of resistance generated.” (GP 1, 32 yr) |
Q10. “In the nursing home setting it’s not a major issue…I’d have to look up their [residents’] notes to see [if they have MDR organism infection or colonisation]…It’s not a big issue for us because we are not a hospital setting, so we wouldn’t isolate someone for example who’s VRE [vancomycin-resistant enterococci] positive.” (NUM 1, 13 yr) | Q12. “From a wound swab point of view, you're more likely to get a resistant bug in an aged care facility than you are in the community…” (GP 2, 20 yr) | |
Q13. “It used to be a really big deal … if someone had MRSA, ‘oh my God’ you know it was the yellow bags and everything came out and we isolated them and we would scrub. Now I mean we wouldn’t even blink if [we see these MDR organisms]. And I don’t think the younger staff realise too the implications of someone having MRSA. But now it's nothing, no one really cares.” (NUM 10, 23 yr) |