Highlights
- •Little is known of the possible pitfalls of long-term antibiotic use.
- •Patients on long-term antibiotics had a good understanding of their indication for prolonged therapy.
- •Despite >40% experiencing side effects attributed to prolonged antibiotic therapy, adherence was high.
- •Patients on long term antibiotics may be carriers of multi-resistant organisms.
Abstract
Background
Some patients receive long-term or life-long antibiotics for suppression of infections
deemed otherwise incurable. Little is known about the consequences of this strategy.
We aimed to explore patients' attitudes towards and knowledge concerning prolonged
antibiotic therapy.
Methods
A cross-sectional cohort pilot study of outpatients on long-term antibiotics was performed.
Surveys were conducted at our healthcare network in Victoria, Australia between April
and December 2015. Microbiological screening for multi-resistant organisms (MRO) was
also performed.
Results
Heterogeneity was noted in the prescribed antibiotics and documented indications,
with rifampicin and fusidic acid for suppression of prosthetic joint infection the
most common regimen and indication. 41% (12/29) of participants reported side-effects
attributed to their antibiotics, but 72% (21/29) still declared complete adherence
to their prescribed regimen. 76% (22/29) of participants stated that they would cease
their long-term antibiotics based on medical advice. 19/29 (66%) participants consented
to microbiological screening and 4 were found to be colonised with MROs. They had
spent more days as an inpatient in the preceding 12 months than the screened participants
who were not colonised.
Conclusion
Participants in this study had a good understanding of their infection and the indications
for their long-term antibiotic therapy, and were adherent to this therapy despite
many experiencing side-effects attributed to their antibiotics. Patients who are prescribed
life-long antibiotics can be carriers of multi-resistant organisms, but both the drivers
of this resistance, and the broader impact of colonisation with MRO in this population
is unclear.
Keywords
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Article info
Publication history
Published online: June 19, 2019
Accepted:
May 26,
2019
Received in revised form:
May 19,
2019
Received:
March 31,
2019
Identification
Copyright
Crown Copyright © 2019 Published by Elsevier B.V. on behalf of Australasian College for Infection Prevention and Control. All rights reserved.
