Infections in the elderly

Ageing of the immune system is a complex process involving both humoral and cell mediated immunity. Along with decline in immunity, morphological changes in various organ makes the elderly especially vulnerable to infection. In clinical practice, infections of respiratory tract and urinary tract, endocarditis, septicaemia and tuberculosis are commonly encountered in elderly subjects Atypical clinical presentation, slow response to treatment and high mortality are hall marks of infection in order patients. Antibiotic therapy in elderly needs to be early, empirical and broad spectrum through parenteral route, with early change over to oral therapy. Aminopenicillins and cephalosporins are safer drugs in old age as compared to aminoglycosides. Pneumococcal and influenza vaccines are recommended in elderly subjects with medical conditions with higher risk of mortality and complications.