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Invited Commentary
July 12, 2021

Reducing Antimicrobial Use Among Nursing Home Residents With Advanced Dementia: The Need for Practical Tools

Author Affiliations
  • 1Department of Internal Medicine, Division of Infectious Diseases, University of Michigan, Ann Arbor
JAMA Intern Med. 2021;181(9):1183-1184. doi:10.1001/jamainternmed.2021.3243

Nursing home residents with advanced dementia are often prescribed antibiotics for suspected infections.1 Nonspecific presenting symptoms, high rates of bacterial colonization, and complex family dynamics are among the myriad of factors that exacerbate inappropriate antibiotic use. While antibiotics are often viewed as less burdensome compared with other interventions, these medications are not therapeutically neutral. Antibiotics increase the risk of acquisition and transmission of multidrug resistant organisms, as well as drug interactions and other adverse effects. The need to improve antimicrobial prescribing for patients with advanced dementia is widely recognized; however, high quality, pragmatic trials to guide such efforts have been lacking.

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