Recently, the CDC released the Core Elements for Antibiotic Stewardship for Nursing Homes to provide guidance to Long Term Care (LTC) facilities related to antibiotic prescribing practices. The CDC guidelines are designed to reduce antibiotic overuse and decrease the alarming rise in antibiotic resistant infections. (2) Antibiotics provide an astonishing value to healthcare, however, over prescribing these drugs threatens the longevity of their effectiveness due to the ability of bacteria to develop defense mechanisms and resistance to antibiotics. Newly emerging antibiotic therapies are not being developed fast enough to keep up with the growing resistance capabilities of bacteria. (7) Our practices need to change to protect current therapeutic drugs and still meet the healthcare needs of our residents.
Urinary tract infections (UTIs) are a serious concern in the LTC setting, and are ultimately responsible for frequent repetitive antibiotic use in the elderly. UTIs account for approximately 30 % of all infections and up to 50% of antibiotic use in the elderly residing in LTC facilities. (3,5) Complications from UTI’s can include bacteremia, cystitis, pyelonephritis, falls and septic shock. It is important to remember that UTI’s can mimic symptoms of Alzheimer’s disease and senile dementia. An estimated 1 in 10 nursing home residents has a UTI and nearly half of these residents will not exhibit typical signs and symptoms of infection, such as fever. (5,9) Falls have been shown to increase over 30-60% in residents with moderate to severe urinary tract infections. (8)
How can UTI’s be prevented? Several preventative measures can help minimize the risk of developing a UTI. These include adequate hydration, emptying the bladder when the need to urinate occurs, excellent perineal cleanliness and of course supplementing the diet with cranberries and D-Mannose (1,4). Incorporating a cranberry and D-Mannose supplement works naturally to interfere with bacterial adherence to the bladder walls, where infection of the mucosal surface can occur. E-Coli entering the bladder is the most common cause of UTIs. (4)
DermaRite’s UTI Heal is an excellent product to promote urinary health in your residents. UTI Heal contains Cranberry, D-Mannose, Inulin (FOS) and Erythritol. Taken in a great tasting 1 ounce serving, the cranberry and D-Mannose in UTI Heal promote an environment that inhibits the proliferation of infection causing bacteria in the bladder. Additionally, Inulin promotes digestive health by stimulating beneficial bacterial growth and reducing harmful bacteria that can lead to infections.
As with all of DermaRite’s nutritional products, UTI Heal is sugar-free, gluten-free, and lactose-free to meet the dietary requirements of your residents.
- US National Library of Medicine: Cranberry. Retrieved October 21, 2015. https://www.nlm.nih.gov/medlineplus/druginfo/natural/958.html
- Centers for Disease Control and Prevention. The Core Elements of Antibiotic Stewardship for Nursing Homes. Retrieved October 21, 2015. http://www.cdc.gov/longtermcare/prevention/antibiotic-stewardship.html
- Centers for Disease Control and Prevention. Urinary Tract Infection (UTI) Event for Long-term Care Faciliites. Retrieved October 22, 2015. http://www.cdc.gov/nhsn/PDFs/LTC/LTCF-UTI-protocol_FINAL_8-24-2012.pdf
- Recurrent Urinary Tract Infections in Adult Women: a Plot study With Ora D-Mannose. Retrieved Oct. 23, 2015. https://www.clinicaltrials.gov/ct2/show/NCT01808755
- Buhr, G. & Genao, L. (2013). Urinary Tract Infections in Older Adults Residing in Long-Term Care Facilities. Retrieved October 22, 2015. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3573848/
- Drugs Today 2007, 43(1): 47 ISSN 1699-3993 Copyright 2007 Prous Science
CCC: 1699-3993 DOI: 10.1358/dot.2007.43.1.1032055
- Lieberman, P., & Wootan, M. (1988). Protecting the Crown Jewels of Medicine. Retrieved October 20, 2015. http://cspinet.org/reports/abiotic.htm
- Rhoads J1, Clayman A, Nelson S. The relationship of urinary tract infections and falls in a nursing home. Director. 2007 Winter;15(1):22-6.Retrieved 10/26/15 http://www.ncbi.nlm.nih.gov/pubmed/19348053
- Sollitto M. Urinary tract infections in the elderly. Retrieved 10/26/15: https://www.agingcare.com/Articles/urinary-tract-infections-elderly-146026.htm
Want to learn more about this topic? In addition to the reference links above, here are some great articles and resources that you can explore.
- The Washington Post – A ‘superbug’ emerges in China to remind us that antibiotics won’t last forever https://www.washingtonpost.com/rweb/politics/a-superbug-emerges-in-china-to-remind-us-that-antibiotics-wont-last-forever/2015/11/19/92bf0db3b3b1d57ba21e12fa1c18c916_story.html
- CDC.gov – The Core Elements of Antibiotic Stewardship for Nursing Homes http://www.cdc.gov/longtermcare/prevention/antibiotic-stewardship.html
- McKnights.com – CDC: Up to 3 in 4 SNF Antibiotics Drug Orders Wrong http://www.mcknights.com/news/cdc-up-to-3-in-4-snf-antibiotics-drug-orders-wrong/article/444886/
- MDPI.com – Antimicrobial Stewardship and Urinary Tract Infections http://www.mdpi.com/2079-6382/3/2/174