[Therapeutic principles of bronchopulmonary infections in the aged]

Airways and lungs are equipped with a highly effective defense mechanism. These can bei found damaged in the aged: Cough is weaker, mucociliary clearance and mucous production are irregular. This damage can bei caused and increased by smoking, recurrent infection, and some sorts of air pollution (SO2). We call it a primary infection, when the organ has been intact as well as the general condition (immune defense etc), and where the causative agent is a virus or virus-like organism. A secondary infection is conditioned by previous disease, and when the causative agents are bacilli. Finally, a tertiary infection is dependent on a defense failure of the body and on opportunistic organisms. For elderly patients, secondary infections outweight the others (recurrent purulent bronchitits). However, tertiary infections must also bei considered in bedridden or post-operative patients or in those with metabolic disease. Finally, pneumonia in the aged must be differentiated in terms of underlying carcinoma, infarction, aspiration and tuberculosis. Therapy of primary (viral)infection consists mainly in prophylaxis of bacterial secondary infection. The choice of drug, dosage and duration of treatment depends on the degree of previous damage to the organ, of complications and status of the whole body and it's defense mechanisms.