Antimicrobial Stewardship in Long-Term Care Facilities

CDPHE supports stewardship in skilled nursing facilities/nursing homes with tools and resources. CDC provides a framework for antimicrobial stewardship with the Core Elements of Antibiotic Stewardship for Nursing Homes. Prescribers, nurses, and other members of a care team can use these resources to support antimicrobial stewardship in nursing homes. 

CDPHE Toolkits for Long-term Care Facilities

The LTCF Respiratory Viruses and Antimicrobial Stewardship Toolkit contains links to key resources to support antimicrobial stewardship when respiratory viruses are prevalent.

CDPHE’s Antibiotic Tracking Tool for LTCF. CDPHE’s Antibiotic Tracking Tool for LTCF. Please utilize this tool within Google Sheets to track antibiotic usage and infection types among residents. If you need to work with an Excel file of the tool, please email us with your request. 

Antibiotic use in nursing homes: a summary of guideline recommendations for common indications. This is a summary of existing published evidence-based guidance for urinary tract infection, community-acquired bacterial pneumonia, and skin and soft tissue infection. This summary is a tool to assist outpatient nursing home antimicrobial stewardship programs to support goals of “right antibiotic,” “right dose,” and “right duration.”

Comparison of testing methods for urinary tract infections wall chart - Urinary tract infections are the most frequently diagnosed infections in the nursing home setting. Use this wall chart and additional information to compare testing methods of urine culture to molecular testing , such as polymerase chain reaction (PCR) and next-generation sequencing (NGS). 

Antibiotic Time-Out Checklist - Use this checklist can be utilized to take a Time-Out to reassess appropriateness of an antibiotic within 48-72 hours after the antibiotic start date.

Suspected Urinary Tract Infection (UTI) Action Tool - This resource can guide nursing staff in the initial evaluation of possible UTI in residents without a urinary catheter.

Talking with Residents and Family Members about Antibiotics - AHRQ. This resource provides communication examples for care team staff when discussing UTIs and appropriate use of antibiotics with residents and family members.

Antibiogram quick guide  - This one-page resource describes the interpretation and important role of antibiograms in nursing homes. 

Colorado nursing home antibiogram

Antibiogram for gram-positive bacteria in nursing homes submitting antimicrobial resistance data - Colorado, 2023 (n=196 nursing homes)