KEYWORDS:
adult immunization

BACKGROUND:
In 2001, 19 long-term care (LTC) facilities in Idaho were assessed for influenza and pneumococcal immunization coverage rates for 2000-2001. Additional chart information was abstracted for episodes of antibiotic use for documented respiratory infections.

OBJECTIVE(S):
To determine the impact of influenza and pneumococcal immunization on use of antibiotics to treat respiratory infections in LTC residents.

METHOD(S):
Chart review of all LTC residents between 9/1/00 and 2/28/01. Supplemental data were used when available, including immunization logs and pharmacy records. All respiratory infections requiring antibiotic treatment for ³ 5 days were included. Patients with short stays (£ 45 days) were excluded.

RESULT(S):
1,028 charts were reviewed. Overall, 70% of residents received influenza vaccine (range 37-93%) and 45% received pneumococcal vaccine (range 0-93%). 405 (39%) residents were current for both influenza and pneumococcal immunization. Female residents were more likely to receive influenza vaccine than males (72% versus 66%, p<0.06) and were significantly more likely to receive pneumococcal vaccine (48% versus 37%, p<0.001). 523 (51%) residents received antibiotics during the study period, with 284 (27%) residents receiving antibiotics for a respiratory illness. Residents receiving influenza vaccine, pneumococcal vaccine, or both vaccines had similar antibiotic use when compared to unvaccinated residents, with 28% versus 27% of residents in each group receiving antibiotics. Female residents were significantly more likely to receive a course of antibiotics for a respiratory infection than male residents (31% versus 19%, p<0.001).

CONCLUSIONS(S):
Immunization status did not appear to affect the incidence of antibiotic use for respiratory illness. Females were more likely to receive both vaccination and antibiotics for respiratory illness. Limitations include the fact that we were unable to determine the appropriateness of the antibiotics prescribed. Further research is needed into the relationship between immunization and respiratory illness.

LEARNING OBJECTIVES:
Understand the use of antibiotics for respiratory infections in long-term care residents.