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[Antibiotic therapy in the elderly: features and problems].

Michele Russo¹, Loredana Iasimone, Ersilia Ambrosino

¹Cattedra di Malattie Infettive, Facoltà di Medicina e Chirurgia, Seconda Università degli Studi di Napoli, Naples.

Le Infezioni in Medicina

|May 20, 2003

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Bacterial infections are a major threat to older adults, causing many deaths and hospitalizations. Recognizing atypical symptoms and managing drug interactions are crucial for effective treatment and preventing antibiotic resistance in the elderly.

Area of Science:

Gerontology
Infectious Diseases
Pharmacology

Context:

Bacterial infections disproportionately affect the elderly, contributing to 30% of deaths in this population and being a leading cause of hospitalization.
Atypical presentations of infection in aged patients, such as altered mental status, complicate diagnosis, as classic signs like fever and leukocytosis may be absent.
The elderly population often presents with comorbidities and polypharmacy, increasing the risk of adverse drug interactions with antibiotics.

Purpose:

To highlight the diagnostic challenges and therapeutic complexities of bacterial infections in the elderly.
To emphasize the importance of considering age-related physiological changes and drug interactions in antimicrobial therapy.
To underscore the need for careful drug selection, monitoring, and appropriate empirical treatment in this vulnerable demographic.

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Summary:

Bacterial infections in the elderly are challenging due to atypical symptoms, frequent noncompliance, and potential drug-drug interactions.
Age-related decline in renal function impacts antibiotic excretion, necessitating careful drug selection and monitoring for toxicity.
Common infections include pneumonia, UTIs, and intra-abdominal infections, with increasing rates of meningitis and endocarditis, demanding tailored therapeutic strategies.

Impact:

Improved clinical recognition and management of bacterial infections in elderly patients.
Reduced morbidity and mortality through optimized antibiotic selection and monitoring.
Mitigation of antibiotic resistance by ensuring adherence and appropriate empirical therapy.