van Heijl Inger, Schweitzer Valentijn A, Zhang Lufang, van der Linden Paul D, van Werkhoven Cornelis H, Postma Douwe F
Department of Clinical Pharmacy, Tergooi Hospital, Van Riebeeckweg 212, Post Box 10016, Hilversum, 1201 DA, The Netherlands.
Julius Center for Health Sciences and Primary care, University Medical Centre Utrecht, Heidelberglaan 100, Post Box 85500, Utrecht, 3508 GA, The Netherlands.
Drugs Aging. 2018 May;35(5):389-398. doi: 10.1007/s40266-018-0541-7.
The elderly are more susceptible to infections, which is reflected in the incidence and mortality of lower respiratory tract infections (LRTIs) increasing with age. Several aspects of antimicrobial use for LRTIs in elderly patients should be considered to determine appropriateness. We discuss possible differences in microbial etiology between elderly and younger adults, definitions of inappropriate antimicrobial use for LRTIs currently found in the literature, along with their results, and the possible negative impact of antimicrobial therapy at both an individual and community level. Finally, we propose that both antimicrobial stewardship interventions and novel rapid diagnostic techniques may optimize antimicrobial use in elderly patients with LRTIs.
老年人更容易受到感染，这体现在下呼吸道感染（LRTIs）的发病率和死亡率随年龄增长而增加。在确定老年患者LRTIs抗菌药物使用的适宜性时，应考虑几个方面。我们讨论了老年人与年轻人在微生物病因方面可能存在的差异、目前文献中发现的LRTIs不适当抗菌药物使用的定义及其结果，以及抗菌治疗在个体和社区层面可能产生的负面影响。最后，我们建议抗菌药物管理干预措施和新型快速诊断技术都可以优化老年LRTIs患者的抗菌药物使用。
