Wilson Catherine, Seaton Ronald Andrew
Department of Infectious Diseases, Queen Elizabeth University Hospital, Glasgow, UK.
Scottish Antimicrobial Prescribing Group, Healthcare Improvement Scotland, Scotland, UK.
Br J Hosp Med (Lond). 2024 Nov 30;85(11):1-12. doi: 10.12968/hmed.2024.0233.
Antimicrobial therapy is essential to modern healthcare practice. However, years of injudicious use has contributed to the development of population and individual level harm from antimicrobial resistance. The frail elderly are particularly at risk from infection as well as antimicrobial adverse effects due to multimorbidity, polypharmacy and declining physiological reserve. Diagnosis and management decision making may be challenging in this vulnerable group due to subtle or absent symptoms and signs. Antimicrobial stewardship is the systematic approach to safe and effective use of antimicrobials to optimise outcomes, minimise harm and preserve future therapies. Herein, we consider the significance and importance of antimicrobial stewardship in the frail elderly and suggest ten steps to assist clinicians in the recognition, investigation and management of infection in this group.
抗菌治疗是现代医疗实践的重要组成部分。然而，多年来的不合理使用已导致抗菌药物耐药性在人群和个体层面造成危害。体弱的老年人由于患有多种疾病、使用多种药物以及生理储备下降，特别容易受到感染以及抗菌药物不良反应的影响。由于症状和体征不明显或缺乏，对这一弱势群体进行诊断和管理决策可能具有挑战性。抗菌药物管理是一种系统方法，旨在安全有效地使用抗菌药物，以优化治疗效果、减少危害并保留未来的治疗方法。在此，我们探讨抗菌药物管理在体弱老年人中的意义和重要性，并提出十个步骤，以协助临床医生识别、调查和管理该群体的感染情况。
