Loeb Criteria via Telemedicine: Assessing for Infection in LTCF Residents

Pneumonia and urinary tract infections (UTI) are 2 of the most common diagnoses of residents of long-term care facilities (LTCF), accounting for over 40% of antibiotic use. However, studies have repeatedly shown much of the antibiotic prescribing to be unnecessary. The Loeb criteria, a tool for antibiotic stewardship, is an established minimum set of signs and symptoms to be met for initiation of antibiotics in LTCF residents. This criteria has been shown to be effective in decreasing unnecessary antibiotic use, without increasing hospitalizations or mortality. The expansion of telemedicine with the COVID-19 pandemic has shown potential for improving clinical outcomes for LTCF residents. We performed a review of the literature to determine if there is evidence to support use of telemedicine as a tool to apply the Loeb criteria in making the decision to initiate antibiotics for pneumonia and UTI in LTCF residents.