{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T18:36:46Z","timestamp":1775068606673,"version":"3.50.1"},"reference-count":30,"publisher":"Cambridge University Press (CUP)","issue":"12","license":[{"start":{"date-parts":[[2015,1,2]],"date-time":"2015-01-02T00:00:00Z","timestamp":1420156800000},"content-version":"unspecified","delay-in-days":762,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Infect Control Hosp Epidemiol"],"published-print":{"date-parts":[[2012,12]]},"abstract":"<jats:sec id=\"S0195941700050499_abs1\"><jats:title>Design.<\/jats:title><jats:p>We introduced a long-term care facility (LTCF) infectious disease (ID) consultation service (LID service) that provides on-site consultations to residents of a Veterans Affairs (VA) LTCF. We determined the impact of the LID service on antimicrobial use and <jats:italic>Clostridium difficile<\/jats:italic> infections at the LTCF.<\/jats:p><\/jats:sec><jats:sec id=\"S0195941700050499_abs2\"><jats:title>Setting.<\/jats:title><jats:p>A 160-bed VA LTCF.<\/jats:p><\/jats:sec><jats:sec id=\"S0195941700050499_abs3\"><jats:title>Methods.<\/jats:title><jats:p>Systemic antimicrobial use and positive <jats:italic>C. difficile<\/jats:italic> tests at the LTCF were compared for the 36 months before and the 18 months after the initiation of the ID consultation service through segmented regression analysis of an interrupted time series.<\/jats:p><\/jats:sec><jats:sec id=\"S0195941700050499_abs4\"><jats:title>Results.<\/jats:title><jats:p>Relative to that in the preintervention period, total systemic antibiotic administration decreased by 30% (<jats:italic>P<\/jats:italic>&lt;.001), with significant reductions in both oral (32%; <jats:italic>P<\/jats:italic>&lt;.001) and intravenous (25%; <jats:italic>P<\/jats:italic> = .008) agents. The greatest reductions were seen for tetracyclines (64%; <jats:italic>P<\/jats:italic>&lt;.001), clindamycin (61%; <jats:italic>P<\/jats:italic>&lt;.001), sulfamethoxazole\/trimethoprim (38%; <jats:italic>P<\/jats:italic>&lt;.001), fluoroquinolones (38%; <jats:italic>P<\/jats:italic>&lt;.001), and <jats:italic>\u03b2<\/jats:italic> lactam\/<jats:italic>\u03b2<\/jats:italic>-lactamase inhibitor combinations (28%; <jats:italic>P<\/jats:italic>&lt;.001). The rate of positive <jats:italic>C. difficile<\/jats:italic> tests at the LTCF declined in the postintervention period relative to preintervention rates (<jats:italic>P<\/jats:italic> = .04).<\/jats:p><\/jats:sec><jats:sec id=\"S0195941700050499_abs5\"><jats:title>Conclusions.<\/jats:title><jats:p>Implementation of an LTCF ID service led to a significant reduction in total antimicrobial use. Bringing providers with ID expertise to the LTCF represents a new and effective means to achieve antimicrobial stewardship.<\/jats:p><\/jats:sec>","DOI":"10.1086\/668429","type":"journal-article","created":{"date-parts":[[2012,10,25]],"date-time":"2012-10-25T18:29:22Z","timestamp":1351189762000},"page":"1185-1192","source":"Crossref","is-referenced-by-count":109,"title":["Effective Antimicrobial Stewardship in a Long-Term Care Facility through an Infectious Disease Consultation Service: Keeping a LID on Antibiotic Use"],"prefix":"10.1017","volume":"33","author":[{"given":"Robin L. P.","family":"Jump","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Danielle M.","family":"Olds","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nasim","family":"Seifi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Georgios","family":"Kypriotakis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucy A.","family":"Jury","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily P.","family":"Peron","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amy A.","family":"Hirsch","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul E.","family":"Drawz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brook","family":"Watts","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert A.","family":"Bonomo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Curtis J.","family":"Donskey","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2015,1,2]]},"reference":[{"key":"S0195941700050499_ref018","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2007.01250.x"},{"key":"S0195941700050499_ref002","volume-title":"Health, United States, 2010: With Special Feature on Death and Dying","year":"2011"},{"key":"S0195941700050499_ref001","first-page":"1","article-title":"The National Nursing Home Survey: 2004 overview","volume":"167","author":"Jones","year":"2009","journal-title":"Vital Health Stat"},{"key":"S0195941700050499_ref019","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1136\/bmj.38602.586343.55","article-title":"Effect of a multifaceted intervention on number of antimicrobial prescriptions for suspected urinary tract infections in residents of nursing homes: cluster randomised controlled trial","volume":"331","author":"Loeb","year":"2005","journal-title":"BMJ"},{"key":"S0195941700050499_ref028","doi-asserted-by":"publisher","DOI":"10.1086\/660855"},{"key":"S0195941700050499_ref030","first-page":"20","article-title":"Antibiotic stewardship programs in long-term care facilities","volume":"19","author":"Smith","year":"2011","journal-title":"Ann Long-Term Care Clin Care Aging"},{"key":"S0195941700050499_ref025","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cir672"},{"key":"S0195941700050499_ref014","volume-title":"The Theory and Practice of Econometrics","author":"Judge","year":"1980"},{"key":"S0195941700050499_ref016","volume-title":"Improved diagnosis and treatment of Clostridium difficile infection in a long-term care facility after initiation of an on-site infectious disease consultation service","author":"Jury","year":"2011"},{"key":"S0195941700050499_ref021","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2008.01967.x"},{"key":"S0195941700050499_ref024","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa051639"},{"key":"S0195941700050499_ref023","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199911253412203"},{"key":"S0195941700050499_ref011","doi-asserted-by":"publisher","DOI":"10.1086\/651706"},{"key":"S0195941700050499_ref006","doi-asserted-by":"publisher","DOI":"10.1086\/656411"},{"key":"S0195941700050499_ref003","unstructured":"US Census Bureau Public Information Office. An older and more diverse nation by midcentury. Release CB08-123, http:\/\/www.census.gov\/newsroom\/releases\/archives\/population\/cb08-123.html. Published August 14, 2008. Accessed March 7, 2012."},{"key":"S0195941700050499_ref005","doi-asserted-by":"crossref","first-page":"268","DOI":"10.3201\/eid0702.010224","article-title":"Emerging health care-associated infections in the geriatric population","volume":"7","author":"Strausbaugh","year":"2001","journal-title":"Emerg Infect Dis"},{"key":"S0195941700050499_ref022","doi-asserted-by":"publisher","DOI":"10.1016\/S0196-6553(96)90009-7"},{"key":"S0195941700050499_ref013","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2710.2002.00430.x"},{"key":"S0195941700050499_ref020","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2007.11.007"},{"key":"S0195941700050499_ref009","doi-asserted-by":"publisher","DOI":"10.1086\/501798"},{"key":"S0195941700050499_ref010","volume-title":"Don't let the steward sail without us: high rate of unnecessary antimicrobial use in long-term care facility","author":"Peron","year":"2010"},{"key":"S0195941700050499_ref008","doi-asserted-by":"publisher","DOI":"10.1086\/521854"},{"key":"S0195941700050499_ref004","doi-asserted-by":"publisher","DOI":"10.1086\/501712"},{"key":"S0195941700050499_ref029","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2008.06.001"},{"key":"S0195941700050499_ref007","doi-asserted-by":"publisher","DOI":"10.1046\/j.1532-5415.2001.4930270.x"},{"key":"S0195941700050499_ref012","doi-asserted-by":"publisher","DOI":"10.3201\/eid1210.060016"},{"key":"S0195941700050499_ref027","doi-asserted-by":"publisher","DOI":"10.1086\/510393"},{"key":"S0195941700050499_ref017","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2007.01251.x"},{"key":"S0195941700050499_ref026","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2008.07.007"},{"key":"S0195941700050499_ref015","doi-asserted-by":"publisher","DOI":"10.3201\/eid1605.071606"}],"container-title":["Infection Control &amp; Hospital Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0195941700050499","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,9,28]],"date-time":"2020-09-28T05:24:29Z","timestamp":1601270669000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0195941700050499\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,12]]},"references-count":30,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2012,12]]}},"alternative-id":["S0195941700050499"],"URL":"https:\/\/doi.org\/10.1086\/668429","relation":{},"ISSN":["0899-823X","1559-6834"],"issn-type":[{"value":"0899-823X","type":"print"},{"value":"1559-6834","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,12]]}}}