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Pharmacokinetics and prescribing in the elderly
1Department of Health Care of the Elderly, King's College School of Medicine and Dentistry, London, UK.
The Journal of Antimicrobial Chemotherapy
|August 1, 1994
Summary
Elderly patients often receive more medications, increasing risks for adverse drug reactions (ADR) and antimicrobial resistance. Understanding age-related pharmacokinetic changes can optimize dosing for older adults, preventing ADR and resistance.
Area of Science:
- Pharmacology
- Geriatrics
- Infectious Diseases
Background:
- Antimicrobial prescribing is higher in the elderly.
- Age-related pharmacokinetic changes can impact drug efficacy and safety.
- Suboptimal dosing may lead to adverse drug reactions (ADR) and antimicrobial resistance.
Purpose of the Study:
- To investigate the impact of aging on antimicrobial pharmacokinetics.
- To explore how pharmacokinetic changes influence treatment response and ADR in older adults.
- To advocate for age-specific dosing strategies to prevent ADR and resistance.
Main Methods:
- Review of pharmacokinetic principles related to aging.
- Analysis of factors affecting antimicrobial drug disposition in the elderly.
- Correlation of pharmacokinetic changes with clinical outcomes like ADR and resistance.
Main Results:
- Aging alters drug metabolism, distribution, and elimination (e.g., reduced renal clearance).
- These changes can affect key pharmacokinetic/pharmacodynamic (PK/PD) parameters like Cmax/MIC and time above MIC.
- Altered PK/PD may predispose older adults to suboptimal response and increased ADR.
Conclusions:
- Knowledge of age-related pharmacokinetic shifts is crucial for optimizing antimicrobial therapy in the elderly.
- Tailored dosing regimens are necessary to improve treatment outcomes and minimize risks.
- Precise dosing can help prevent both adverse drug reactions and the development of bacterial resistance.