Faulkner Carmen M, Cox Heather L, Williamson John C
Department of Pharmacy, Wake Forest University Baptist Medical Center, Winston-Salem, North Carolina 27157, USA.
Clin Infect Dis. 2005 Apr 1;40(7):997-1004. doi: 10.1086/428125. Epub 2005 Mar 4.
Elderly persons consume a significant proportion of health care resources. Antimicrobials are just one class among many pharmaceuticals that are prescribed more frequently to elderly patients than to younger patients. There are unique aspects of antimicrobial use in elderly persons that make prescribing complicated and monitoring unpredictable. Physiologic changes associated with aging result in altered pharmacokinetics, and accurate estimates of renal function cannot be made with standard methods. Together, these qualities make antimicrobial dosing difficult. Because of a higher prevalence of other chronic diseases, there is a greater propensity for polypharmacy and a resulting risk of an adverse event or a significant drug interaction. Lastly, irrespective of altered pharmacokinetics, adverse effects of many antimicrobials are more common in elderly persons, which introduces an added dimension to ensuring safety with antimicrobial therapy.
老年人消耗了相当大比例的医疗保健资源。抗菌药物只是众多药物中的一类，与年轻患者相比，老年患者更频繁地使用这类药物。老年人使用抗菌药物存在一些独特之处，使得处方开具变得复杂，监测结果难以预测。与衰老相关的生理变化会导致药代动力学改变，而且无法用标准方法准确估算肾功能。这些因素共同导致抗菌药物给药困难。由于其他慢性病的患病率较高，多重用药的倾向更大，因而产生不良事件或严重药物相互作用的风险。最后，无论药代动力学如何改变，许多抗菌药物的不良反应在老年人中更为常见，这为确保抗菌治疗的安全性增加了一个层面的问题。
