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Association between SARS-CoV-2 testing and antibiotic use in Swiss long-term care facilities: a retrospective multicentric study

2025/09/03 by Marc Jeanneret, Alexia Roux, Isabella Locatelli +4 · 1 voice
Health Professions · Medicine · Biochemistry, Genetics and Molecular Biology · #Geriatric Care and Nursing Homes #Urinary Tract Infections Management #Antibiotic Resistance in Bacteria

paper · doi:10.1093/jacamr/dlaf198

openalex publication_date 2025/09/03 · openalex created_date 2025/10/26 · openalex updated_date 2026/07/31

Abstract

Abstract Background Acute respiratory infections (ARIs) account for 30% of long-term care facility (LTCF) infections, frequently leading to antibiotics over-prescription. Objectives This study evaluates the impact of SARS-CoV-2 testing on LTCF antibiotic prescriptions. Methods A retrospective study was conducted across 45 LTCFs in Vaud Canton, Switzerland, encompassing 2427 long-stay beds, from July 2021 to June 2023. Monthly data on SARS-CoV-2 tests and antibiotic prescriptions were collected. Using linear regression adjusted for Swiss viral epidemiology, we assessed the association between (i) SARS-CoV-2 testing and (ii) positive test results on antibiotic prescriptions. Results SARS-CoV-2 testing rates in LTCFs varied, ranging from 0.3% to 16% of residents tested per facility, peaking in January 2022, July 2022, and November 2022. Similar trends were observed for SARS-CoV-2 test positivity, except for the last testing peak. Antibiotic prescription rates fluctuated moderately, from 3.9% to 7.4% monthly, with minor peaks in December 2021 and April 2022, and a notable peak in January 2023. No significant association was found between SARS-CoV-2 testing and antibiotic prescriptions (coefficient = −0.03 [95%CI: −0.16; 0.10], P = 0.65). However, positive SARS-CoV-2 tests were negatively associated with prescriptions (coefficient = −0.28 [95%CI: −0.53; −0.03], P = 0.029); a 10% increase in positive tests is associated with a 2.8% reduction in antibiotic prescriptions, with an estimated 3.5 positive tests needed to prevent one prescription. Conclusions Overall testing rates showed no impact on antibiotic prescribing, but positive SARS-CoV-2 results correlated with reduced consumption, suggesting more informed prescribing practices and a reduction in unnecessary antibiotic use.

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