{
  "abstract": "Objectives Inappropriate antibiotic use is a major contributor to antimicrobial resistance. Nursing home (NH) residents are frequently prescribed antibiotics unnecessarily, particularly for urinary tract infections (UTIs)—the most commonly treated infection in this setting. However, studies show that over half of these prescriptions do not meet clinical criteria for a UTI, suggesting substantial overdiagnosis. Such overtreatment may cause more harm than benefit in this vulnerable population.To inform the development of tailored intervention materials for infection prevention and antibiotic stewardship in NHs across eight European countries, we conducted a comprehensive context analysis to identify key challenges and areas for improvement.Method As part of the EU-funded IMAGINE project ( www.imagineproject.eu), three complementary studies were carried out in Denmark, Greece, Hungary, Lithuania, Poland, Slovakia, Slovenia, and Spain:An online questionnaire targeting NH staffStructured in-person qualitative interviews, andAn Infection Prevention and control (IPC) audit of routine care practices.The questionnaire covered practices and beliefs related to infection prevention, UTI diagnosis and management, and antimicrobial stewardship. Interviews explored staff perceptions of factors influencing infection prevention practices antibiotic use. IPC audits assessed availability and use of hygiene-related resources and procedures during personal care tasks.Results A total of 286 NH staff completed the questionnaire, revealing notable differences across countries in training, recognition of UTI symptoms, and perceptions of appropriate antibiotic use. Forty qualitative interviews identified key barriers and facilitators within five thematic areas: the NH environment, staff, physicians, residents, and relatives. The IPC audit included 2,912 observations, documenting significant variability in hand hygiene and use of protective equipment.Conclusions This context analysis highlights both shared and country-specific drivers of inappropriate anti-biotic use in NHs. The findings provide a robust foundation for developing context-sensitive, evidence-informed interventions to improve infection prevention and stewardship practices across European nursing homes.",
  "authors": [
    {
      "affiliations": [
        "Department of Clinical Microbiology, Copenhagen University Hospital – Herlev and Gentofte Hospital, Copenhagen, Denmark"
      ],
      "name": "Jette Nygaard Jensen"
    },
    {
      "affiliations": [
        "Department of Clinical Microbiology, Copenhagen University Hospital – Herlev and Gentofte Hospital, Copenhagen, Denmark"
      ],
      "name": "Anna Marie Theut"
    },
    {
      "affiliations": [
        "Department of Clinical Microbiology, Copenhagen University Hospital – Herlev and Gentofte Hospital, Copenhagen, Denmark"
      ],
      "name": "Valeria Antsupova"
    },
    {
      "affiliations": [
        "Department of Clinical Microbiology, Copenhagen University Hospital – Herlev and Gentofte Hospital, Copenhagen, Denmark"
      ],
      "name": "Tina Marloth"
    },
    {
      "affiliations": [
        "Research Unit for General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark"
      ],
      "name": "Jesper Lykkegaard"
    },
    {
      "affiliations": [
        "Research Unit for General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark"
      ],
      "name": "Malene Plejdrup Hansen"
    },
    {
      "affiliations": [
        "Department of People and Technology, Roskilde University, Roskilde, Denmark"
      ],
      "name": "Alexandra Jønsson"
    },
    {
      "affiliations": [
        "Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol, Barcelona, Spain"
      ],
      "name": "Ana Garcia-Sangenis"
    },
    {
      "affiliations": [
        "Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol, Barcelona, Spain"
      ],
      "name": "Ramon Monfá"
    },
    {
      "affiliations": [
        "Department of Quantitative Methods for Economics and Management, University of Las Pal-mas de Gran Canaria, Las Palmas, Spain"
      ],
      "name": "Laura Vallejo-Torres"
    },
    {
      "affiliations": [
        "Department of Quantitative Methods for Economics and Management, University of Las Pal-mas de Gran Canaria, Las Palmas, Spain"
      ],
      "name": "Beatriz González López-Valcárcel"
    },
    {
      "affiliations": [
        "Department of Quantitative Methods for Economics and Management, University of Las Pal-mas de Gran Canaria, Las Palmas, Spain"
      ],
      "name": "Marina Elistratova"
    },
    {
      "affiliations": [
        "Centre for Family and Community Medicine, the Faculty of Health Sciences, the Medical University of Lodz, Lodz, Poland"
      ],
      "name": "Anna Kowalczyk"
    },
    {
      "affiliations": [
        "Szeged Autumn Nursing Home, Szeged, Hungary"
      ],
      "name": "András Bálint"
    },
    {
      "affiliations": [
        "Department of Clinical Pharmacology, Faculty of Medicine, Slovak Medical University in Bratislava, Bratislava, Slovakia"
      ],
      "name": "Helena Glasova"
    },
    {
      "affiliations": [
        "Institute for Health Care Ethics, Faculty of Nursing and of Professional Health Studies",
        "Office of Clinical Pharmacology, Hepatology, and Internal Medicine, Policlinic",
        "Slovak Medical University in Bratislava, Bratislava, Slovakia"
      ],
      "name": "Jozef Glasa"
    },
    {
      "affiliations": [
        "Department of Social Medicine, School of Medicine, University of Crete, Heraklion, Greece"
      ],
      "name": "Christos Lionis"
    },
    {
      "affiliations": [
        "Department of Social Medicine, School of Medicine, University of Crete, Heraklion, Greece"
      ],
      "name": "Greta Tsoulchai"
    },
    {
      "affiliations": [
        "Department of Social Medicine, School of Medicine, University of Crete, Heraklion, Greece"
      ],
      "name": "Marilena Anastasaki"
    },
    {
      "affiliations": [
        "Department of Family Medicine, Lithuanian University of Health Sciences, Vilnius, Lithuania"
      ],
      "name": "Ruta Radzeviciene"
    },
    {
      "affiliations": [
        "Department of Family Medicine, Lithuanian University of Health Sciences, Vilnius, Lithuania"
      ],
      "name": "Lina Jaruseviciene"
    },
    {
      "affiliations": [
        "Department of Family medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia"
      ],
      "name": "Davorina Petek"
    },
    {
      "affiliations": [
        "Department of Family medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia"
      ],
      "name": "Nina Sodja"
    },
    {
      "affiliations": [
        "Austrian Interdisciplinary Platform on Ageing/OEPIA, Vienna, Austria"
      ],
      "name": "Georg Ruppe"
    },
    {
      "affiliations": [
        "Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol, Barcelona, Spain"
      ],
      "name": "Carl Llor"
    }
  ],
  "title": "081 Exploring drivers of antibiotic overuse in European nursing homes: a multi-country context analysis from the IMAGINE project",
  "uid": "8c195e6f-c85c-5171-94c5-59c5ebdb9c89"
}