# Antimicrobial stewardship in long term care facilities: evidence based interventions, implementation tools, and impact metrics

## TL;DR

This paper reviews antimicrobial stewardship programs in nursing homes, focusing on effective interventions and tools to improve antibiotic use.

## Contribution

The paper provides a synthesis of evidence-based interventions and practical tools for implementing antimicrobial stewardship in long-term care.

## Key findings

- High compliance rates may not reflect true clinical effectiveness in antimicrobial stewardship.
- Evidence-based interventions and tools can guide stewardship in resource-variable nursing homes.
- Proposed metrics aim to measure the impact of stewardship programs.

## Abstract

While Centers for Medicare and Medicaid Services-mandated Antimicrobial Stewardship Programs are now in place across U.S. skilled nursing facilities, reported high rates of compliance may mask persistent gaps in clinical effectiveness. This review summarizes evidence-based antimicrobial stewardship interventions, their impact, and practical tools to support implementation. Resources from Centers for Disease Control and Prevention, Agency for Healthcare Research and Quality, other frameworks, and proposed metrics are highlighted to guide effective stewardship in resource-variable nursing home settings.