Division of Infectious Diseases, Department of Medicine, University of Michigan, 1150 West Medical Center Drive, Ann Arbor, MI 48109-5680, USA.
Division of Infectious Diseases, Department of Medicine, University of Michigan, 1150 West Medical Center Drive, Ann Arbor, MI 48109-5680, USA.
Infect Dis Clin North Am. 2017 Dec;31(4):689-713. doi: 10.1016/j.idc.2017.07.015. Epub 2017 Sep 13.
The incidence of pneumonia increases with age, and is particularly high in patients who reside in long-term care facilities (LTCFs). Mortality rates for pneumonia in older adults are high and have not decreased in the last decade. Atypical symptoms and exacerbation of underlying illnesses should trigger clinical suspicion of pneumonia. Risk factors for multidrug-resistant organisms are more common in older adults, particularly among LTCF residents, and should be considered when making empiric treatment decisions. Monitoring of clinical stability and underlying comorbid conditions, potential drug-drug interactions, and drug-related adverse events are important factors in managing elderly patients with pneumonia.
肺炎的发病率随年龄增长而增加,在长期护理机构(LTCF)居住的患者中尤其高。老年人肺炎的死亡率很高,在过去十年中并未下降。不典型症状和基础疾病恶化应引发对肺炎的临床怀疑。在做出经验性治疗决策时,老年人,尤其是 LTCF 居民中更常见多重耐药菌的危险因素,应予以考虑。监测临床稳定性和潜在合并症、潜在药物相互作用以及与药物相关的不良事件是管理老年肺炎患者的重要因素。