Department of Medicine, Washington University School of Medicine, 660 S. Euclid Avenue, Campus Box 8066, St. Louis, MO 63110, USA.
Divisions of Emergency Medicine and Infectious Diseases, Washington University School of Medicine, 4523 Clayton Avenue, Campus Box 8051, St Louis, MO 63110, USA.
Emerg Med Clin North Am. 2021 May;39(2):379-394. doi: 10.1016/j.emc.2021.01.004. Epub 2021 Mar 23.
Infections in elderly patients can prove diagnostically challenging. Age-related factors affecting the immune system in older individuals contribute to nonspecific presentations. Other age-related factors and chronic conditions have symptoms that may or may not point to an infectious diagnosis. Delay in administration of antimicrobials can lead to poor outcomes; however, unnecessary administration of antimicrobials can lead to increased morbidity and contribute to the emergence of multidrug-resistant organisms. Careful clinical assessment and consideration of patient history and risk factors is crucial. When necessary, antimicrobials should be chosen that are appropriate for the diagnosis and deescalated as soon as possible.
老年患者的感染可能具有诊断挑战性。影响老年人免疫系统的与年龄相关的因素导致非特异性表现。其他与年龄相关的因素和慢性疾病的症状可能指向或不指向感染诊断。延迟使用抗生素会导致不良后果；然而，不必要地使用抗生素会导致发病率增加，并有助于多药耐药菌的出现。仔细的临床评估以及考虑患者的病史和危险因素至关重要。必要时，应选择适合诊断的抗生素，并尽快降级。
