2018
DOI: 10.1007/s40266-018-0541-7
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Inappropriate Use of Antimicrobials for Lower Respiratory Tract Infections in Elderly Patients: Patient- and Community-Related Implications and Possible Interventions

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 negativ… Show more

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Cited by 7 publications
(9 citation statements)
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References 95 publications
(102 reference statements)
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“…These alterations induce a basal systemic inflammatory state, or “inflammaging” ( 110 ), and are associated with an augmented susceptibility to viral infection ( 111 ). High morbidity and mortality are observed in elderly patients with infections, especially those of the respiratory tract ( 112–114 ). This situation could be prevented through vaccination; however, vaccine efficacy in this population is greatly reduced in comparison to that in younger adults ( 115–119 ).…”
Section: Aging and Nutrition And Covid-19mentioning
confidence: 99%
“…These alterations induce a basal systemic inflammatory state, or “inflammaging” ( 110 ), and are associated with an augmented susceptibility to viral infection ( 111 ). High morbidity and mortality are observed in elderly patients with infections, especially those of the respiratory tract ( 112–114 ). This situation could be prevented through vaccination; however, vaccine efficacy in this population is greatly reduced in comparison to that in younger adults ( 115–119 ).…”
Section: Aging and Nutrition And Covid-19mentioning
confidence: 99%
“…Antimicrobial resistance (AMR) is accelerated upon misuse and overuse of antimicrobial agents [ 2 ]. Many reports from different parts of the world indicated a high prevalence of inappropriate or incorrect use of antibiotics both in hospitals and in primary healthcare centers [ 3 8 ]. The Global Action Plan (GAP) on AMR, endorsed by the World Health Organization (WHO) in 2015, considered the optimization of antimicrobial use as one of the important strategic objectives that should be included in developing national action plans to combat AMR [ 9 ].…”
Section: Introductionmentioning
confidence: 99%
“…3 One fifth of the total population in Europe is more than 65 years of age and that proportion may increase up to 25% in 2030. 4 The incidence of RTIs is higher in elderly individuals as compared with young ones, 5,6 as the susceptibility to infections increases with increase in age. 79 The mortality rate in individuals over 65 years of age increases approximately 6–7% with the presence of RTIs 10 because of other co-morbidities, weak immune system and poor response to respiratory vaccines.…”
Section: Introductionmentioning
confidence: 99%
“…13 With presence of other co-morbidities and/or polypharmacy, occurrence of adverse drug reactions and drug–drug interactions also reduces the treatment outcomes of RTIs among elderly individuals. 4…”
Section: Introductionmentioning
confidence: 99%