Appendix C: Minimum Criteria for the Initiation of Antibiotics in Residents of Long-Term Care Facilities: Results of a Consenus Conference

Either new or the purulent drainage increases at a wound, skin, or soft tissue site, or at least two of the following:

A. Fever [temperature >37.9C (100F) or an increase of 1.5C (2.4F) above baseline temperatures taken at any time]

B. Redness C. Tenderness D. Warmth E. Swelling that was new or increasing at the affected site

RESPIRATORY INFECTIONS

A. If the resident is febrile with a temperature >38.9C (102F), at least one of the following:

1. Respiratory rate >25 breaths per minute 2. Productive cough

B. If the resident has a temperature >37.9C (100F) or 1.5C (2.4F) increase above baseline temperature, minimum criteria for initiating antibiotics requires presence of cough and at least one of the following:

1. Pulse >100/min 2. Delirium 3. Rigors (shaking chills) 4. Respiratory rate >25/min

C. For afebrile residents known to have chronic obstructive pulmonary disease classified as high-risk because of age 65, minimum criteria for initiating antibiotics for a suspected respiratory infection include a new or increased cough with purulent sputum production.