TY - JOUR
T1 - Challenges of antimicrobial stewardship among older adults
AU - ESCMID Study group of infections in the elderly (ESGIE)
AU - Alves, Joana
AU - Prendki, Virginie
AU - Chedid, Marie
AU - Yahav, Dafna
AU - Bosetti, Davide
AU - Rello, Jordi
N1 - Publisher Copyright:
© 2024
PY - 2024/6
Y1 - 2024/6
N2 - Older adults hospitalized in internal medicine wards or long-term care facilities (LTCF) are progressively increasing. Older adults with multimorbidity are more susceptible to infections, as well as to more vulnerable to adverse effects (and interactions) of antibiotics, resulting in a need for effective and safer strategies for antimicrobial stewardship (ASM), both in hospitalization wards and long-term care facilities. Studies on antimicrobial stewardship in older patients are scarce and guidelines are required. Given the peculiarities of the optimization of antimicrobial prescription in individual older adults for common infections, tactics to overcome barriers need an update. The use of rapid diagnosis tests, biomarkers, de-escalation and switching from intravenous to oral/subcutaneous therapy strategies are examples of successful AMS interventions. AMS interventions are associated with reduced side effects, lower mortality, shorter hospital stays, and reduced costs. The proposed AMS framework in LTCF should focus on five domains: strategic vision, team, interventions, patient-centred care and awareness. Internists can partner with geriatrists, pharmacists and infectious disease specialists to address barriers and to improve patient care.
AB - Older adults hospitalized in internal medicine wards or long-term care facilities (LTCF) are progressively increasing. Older adults with multimorbidity are more susceptible to infections, as well as to more vulnerable to adverse effects (and interactions) of antibiotics, resulting in a need for effective and safer strategies for antimicrobial stewardship (ASM), both in hospitalization wards and long-term care facilities. Studies on antimicrobial stewardship in older patients are scarce and guidelines are required. Given the peculiarities of the optimization of antimicrobial prescription in individual older adults for common infections, tactics to overcome barriers need an update. The use of rapid diagnosis tests, biomarkers, de-escalation and switching from intravenous to oral/subcutaneous therapy strategies are examples of successful AMS interventions. AMS interventions are associated with reduced side effects, lower mortality, shorter hospital stays, and reduced costs. The proposed AMS framework in LTCF should focus on five domains: strategic vision, team, interventions, patient-centred care and awareness. Internists can partner with geriatrists, pharmacists and infectious disease specialists to address barriers and to improve patient care.
KW - Aging
KW - Antimicrobial optimization
KW - Antimicrobial resistance
KW - Elderly
KW - Long-term care facilities
UR - http://www.scopus.com/inward/record.url?scp=85185800968&partnerID=8YFLogxK
U2 - 10.1016/j.ejim.2024.01.009
DO - 10.1016/j.ejim.2024.01.009
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C2 - 38360513
AN - SCOPUS:85185800968
SN - 0953-6205
VL - 124
SP - 5
EP - 13
JO - European Journal of Internal Medicine
JF - European Journal of Internal Medicine
ER -