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老年患者下呼吸道感染抗菌药物的不当使用:患者及社区相关影响和可能的干预措施

Inappropriate Use of Antimicrobials for Lower Respiratory Tract Infections in Elderly Patients: Patient- and Community-Related Implications and Possible Interventions.

作者信息

van Heijl Inger, Schweitzer Valentijn A, Zhang Lufang, van der Linden Paul D, van Werkhoven Cornelis H, Postma Douwe F

机构信息

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.

出版信息

Drugs Aging. 2018 May;35(5):389-398. doi: 10.1007/s40266-018-0541-7.

Abstract

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.

摘要

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。

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本文引用的文献

1
infection in the elderly: an update on management.老年人感染:管理更新。
Clin Interv Aging. 2017 Oct 24;12:1799-1809. doi: 10.2147/CIA.S149089. eCollection 2017.
3
What is antimicrobial stewardship?什么是抗菌药物管理?
Clin Microbiol Infect. 2017 Nov;23(11):793-798. doi: 10.1016/j.cmi.2017.08.026. Epub 2017 Sep 4.
6
7
The Impact of Reducing Antibiotics on the Transmission of Multidrug-Resistant Organisms.减少抗生素使用对多重耐药菌传播的影响
Infect Control Hosp Epidemiol. 2017 Jun;38(6):663-669. doi: 10.1017/ice.2017.34. Epub 2017 Mar 8.

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