PITTSBURGH (April 11, 2023) – Researchers from the University of Wisconsin-Madison and the University of Pittsburgh School of Medicine are leading a six-month study to explore the treatment of urinary tract infections (UTIs) in skilled nursing facilities (SNFs) utilizing ILÚM Inform and a custom Weighted-Incidence Syndromic Combination Antibiogram (WISCA). The 10 SNFs that are part of this study range from 44-149 beds.
The study aims to improve the quality of empiric antibiotic decisions and assess the impact of antibiotic safety and effectiveness in nursing homes. Empiric antibiotic therapy is treatment given based on population-level evidence with patient-specific considerations, without culture and antibiotic susceptibility test results. When treating an infection empirically, a clinician is faced with two sources of uncertainty: the type(s) of bacteria causing the suspected infection and the likelihood the causative bacteria are susceptible to different antibiotics that might be used.
The research, enabled by ILÚM Inform, ID Connect’s mobile application that provides medical professionals with the most up-to-date ID information to improve antimicrobial prescribing, builds upon previous studies which show that antibiotics are a common cause of avoidable harm in skilled nursing facilities. It is estimated that 47-79% of all SNF residents are prescribed an antibiotic over the course of a year,2,3 and while a certain level of use is unavoidable, up to 75% of antibiotic prescribing in SNFs is either unjustified or sub-optimal.4,5 Skilled nursing facility residents exposed to antibiotics also experience a three-fold higher risk of preventable adverse events,6 and antibiotics are responsible for 20% of all adverse drug events observed in SNFs.7
ILÚM Inform was chosen for the study due to its ability to be customized specifically to each SNF in the study, addressing its unique resource needs and antibiograms or antibiotic prescribing guidelines. Each WISCA is fully customized to the facility, and researchers will have the ability to review all user actions within the app to study the thought process behind each physician’s decision making. Up to 100 providers will download and potentially utilize the fully customized ILÚM Inform WISCA within these facilities to aid in the treatment of UTIs.
“Nursing homes often rely on hospital antibiograms, which can lead to excessive use of broad-spectrum antibiotics. This may cause harm to nursing home residents, a patient population that is very different from average hospital inpatients,” said Rima Abdel-Massih, M.D., co-founder and chief medical officer of ID Connect. “Developing facility-specific antibiograms for nursing home populations has the potential to greatly enhance the quality of empiric antibiotic decisions for these patients. We are proud to support this important research with our custom built ILÚM Inform WISCA app.”
Researchers will analyze antibiotic usage data from six months prior to implementation of the intervention and six months post implementation. The study officially began March 6, 2023, and results are expected in December 2023.
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About Infectious Disease Connect
ID Connect is a world leader in telemedicine-enabled care of infectious diseases, antimicrobial stewardship, and infection control and prevention. Spun out of leading academic medical center UPMC, the company’s technology, precision medicine and data science are paired with world-class ID physicians to effectively manage infectious diseases across the U.S. At ID Connect, we strive to make people healthy, improve outcomes, and keep our communities free of infectious diseases. For more information, go to IDCtelemed.com
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2. Daneman N, Bronskill SE, Gruneir A, Newman AM, Fischer HD, Rochon PA, et al. Variability in antibiotic use across nursing homes and the risk of antibiotic-related adverse outcomes for individual residents. JAMA Internal Medicine. 2015; 175(8): 1331–9. PMID: 23552741
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6. Field TS, Gurwitz JH, Avorn J, McCormick D, Jain S, Eckler M, et al. Risk factors for adverse drug events among nursing home residents. Arch Intern Med. 2001; 161(13): 1629–34. PMID: 11434795
7. Gurwitz JH, Field TS, Avorn J, McCormick D, Jain S, Eckler M, et al. Incidence and preventability of adverse drug events in nursing homes. Am. J. Med. 2000; 109(2): 87–94. PMID: 10967148