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Considerations for ...
Considerations for the optimal management of antibiotic therapy in elderly patients
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- Falcone, Marco (author)
- Univ Pisa, Dept Clin & Expt Med, Via Paradisa 2, I-56124 Pisa, Italy.
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- Paul, Mical (author)
- Technion Israel Inst Technol, Rambam Hlth Care Ctr, Div Infect Dis, Haifa, Israel.;Technion Israel Inst Technol, Ruth & Bruce Rappaport Fac Med, Haifa, Israel.
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- Tiseo, Giusy (author)
- Univ Pisa, Dept Clin & Expt Med, Via Paradisa 2, I-56124 Pisa, Italy.
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- Yahav, Dafna (author)
- Beilinson Med Ctr, Rabin Med Ctr, Infect Dis Unit, Petah Tiqwa, Israel.
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- Prendki, Virginie (author)
- Geneva Univ Hosp, Dept Rehabil & Geriatr, Div Internal Med Aged, Geneva, Switzerland.;Univ Geneva, Hop Trois Chene, Geneva, Switzerland.
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- Friberg, Lena (author)
- Uppsala universitet,Institutionen för farmaceutisk biovetenskap
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- Guerri, Roberto (author)
- Univ Autonoma Barcelona, Hosp del Mar, Infect Dis Dept, Dept Med, Barcelona, Spain.
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- Gavazzi, Gaetan (author)
- Univ Grenoble Alpes, Univ Hosp Grenoble Alpes, Univ Clin Geriatr, GREPI EA7408, Grenoble, France.
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- Mussini, Cristina (author)
- Univ Modena & Reggio Emilia, Clin Infect Dis, Modena, Italy.
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- Tinelli, Marco (author)
- Hosp Lodi, Div Infect & Trop Dis, Lodi, Italy.
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Univ Pisa, Dept Clin & Expt Med, Via Paradisa 2, I-56124 Pisa, Italy Technion Israel Inst Technol, Rambam Hlth Care Ctr, Div Infect Dis, Haifa, Israel.;Technion Israel Inst Technol, Ruth & Bruce Rappaport Fac Med, Haifa, Israel. (creator_code:org_t)
- ELSEVIER SCI LTD, 2020
- 2020
- English.
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In: Journal of Global Antimicrobial Resistance. - : ELSEVIER SCI LTD. - 2213-7165 .- 2213-7173. ; 22, s. 325-333
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Abstract
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- Objectives: To maximise efficacy and minimise toxicity, special considerations are required for antibiotic prescription in elderly patients. This review aims to provide practical suggestions for the optimal management of antibiotic therapy in elderly patients. Methods: This was a narrative review. A literature search of published articles in the last 15 years on antibiotics and elderly patients was performed using the Cochrane Library and PubMed electronic databases. The three priority areas were identified: (i) pharmacokinetics/pharmacodynamics (PK/PD) for optimising dosage regimens and route of administration; (ii) antibiotic dosages in some special subpopulations; and (iii) treatment considerations relating to different antibiotic classes and their adverse events. Results: Clinicians should understand the altered PK/PD of drugs in this population owing to co-morbid conditions and normal physiological changes associated with ageing. The body of evidence justifies the need for individualised dose selection, especially in patients with impaired renal and liver function. Clinicians should be aware of the major drug-drug interactions commonly observed in the elderly as well as potential side effects. Conclusion: Antibiotic therapy in the elderly requires a comprehensive approach, including strategies to improve appropriate antibiotic prescribing, limit their use for uncomplicated infections and ensure the attainment of an optimal PK/PD target. To this purpose, further studies involving the elderly are needed to better understand the PK of antibiotics. Moreover, it is necessary to assess the role therapeutic drug monitoring in guiding antibiotic therapy in elderly patients in order to evaluate its impact on clinical outcome.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Medicinska och farmaceutiska grundvetenskaper -- Farmakologi och toxikologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Basic Medicine -- Pharmacology and Toxicology (hsv//eng)
Keyword
- Elderly
- Pharmacokinetics
- Pharmacodynamics
- Antibiotics
- Dosage
- Adverse events
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- ref (subject category)
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- By the author/editor
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Falcone, Marco
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Paul, Mical
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Tiseo, Giusy
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Yahav, Dafna
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Prendki, Virgini ...
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Friberg, Lena
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Guerri, Roberto
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Gavazzi, Gaetan
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Mussini, Cristin ...
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Tinelli, Marco
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Basic Medicine
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and Pharmacology and ...
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Uppsala University