ANTIMICROBIAL THERAPY IN THE ELDERLY
Section snippets
UNIQUE CONSIDERATIONS IN THE ELDERLY
Infectious diseases in older persons compared with younger individuals are relatively more frequent and severe.44 The elderly also suffer greater complications of these infections, which eventually contribute to a higher mortality. Infections in aging adults that are associated with increased morbidity include pneumonia, often complicated by bacteremia, extrapulmonary sites of infection, delayed resolution, and pulmonary function compromise; tuberculosis infection and disease, which is prone to
PRINCIPLES OF ANTIBIOTIC THERAPY
When selecting antibiotics for a specific infection in the elderly patient, the unique problems and issues mentioned earlier must be taken into consideration. Because of the high risk of complications and death resulting from infections, the diverse infectious causes, and the difficulty in obtaining diagnostic specimens, initial empiric antibiotic therapy selection for specific infections is a valid and practical option.19 The empiric use of antibiotics for specific infections in the elderly is
USE OF SPECIFIC ANTIBIOTICS
This discussion focuses on specific classes of antibiotics that are particularly relevant and important for the treatment of bacterial infections in the aging patient.
EMPIRIC USE OF ANTIBIOTICS
The empiric selection of antibiotics should take into consideration the most likely sites and causes of infection, clinical status of the patient, comparative efficacy of antibiotics that could be selected under similar circumstances, potential adverse effects of the drugs, and overall costs incurred in use of the drug.66 The empiric antibiotic regimen ideally should be subsequently replaced by a more focused regimen based on microbiologic data that indicate a specific cause, when possible
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Procalcitonin in elderly patients: State of the Art
2010, AntibiotiquesInfection in the Elderly
2007, Infectious Disease Clinics of North AmericaCitation Excerpt :This reduces the empiric usage of broad-spectrum antibiotics and emergence of resistant pathogens. Longer duration of antibiotic therapy is needed in the elderly population compared with young adults [97,103,104,108]. Choice of oral antimicrobials includes trimethoprim-sulfamethoxazole, second-generation cephalosporins, fluoroquinolones, or nitrofurantoin.
Bacteremia and Sepsis in Older Adults
2007, Clinics in Geriatric MedicineCitation Excerpt :One study of 811 septic patients found that tachypnea and altered mentation were more common among patients aged more than 75 years than among younger patients, whereas tachycardia and hypoxemia were less common among older patients [29]. Other nonspecific expressions of infection in the elderly may include anorexia, malaise, generalized weakness, falls, and urinary incontinence [30]. Clinicians should have a heightened suspicion for infection when evaluating older patients with such symptoms.
Infectious Emergencies in the Elderly
2006, Emergency Medicine Clinics of North AmericaCitation Excerpt :These factors will determine whether the therapy should be administered orally or parenterally. MSRA and streptococci are treated with first-generation cephalosporins, antistaphylococcal penicillins, and clindamycin in penicillin allergic patients [16,18]. Polymicrobial infections frequently occur in decubiti and diabetic ulcerations.
Antimicrobial therapy and resistance in dermatologic pathogens of the elderly
2004, Dermatologic Clinics
Address reprint requests to Shobita Rajagopalan, MD, Department of Internal Medicine, MP 11, Charles R. Drew University of Medicine and Science, King-Drew Medical Center, 12021 S. Wilmington Avenue, Los Angeles, CA 90059. e-mail: [email protected]
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Department of Internal Medicine, Division of Infectious Disease, Charles R. Drew University of Medicine and Science, King-Drew Medical Center, Los Angeles, California