Infectious disease clinics of North America
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Misuse and overuse of antibiotic therapy is a frequent cause of resident harm in nursing facilities. As a result, newly released policy and regulatory initiatives will require antibiotic stewardship programs (ASPs) in nursing facilities. Although implementing ASPs can be challenging, improving the quality of antibiotic prescribing is achievable in this setting. The authors review the determinants of antibiotic prescribing in nursing facilities, strategies to improve antibiotic prescribing in this setting, current status of ASPs in nursing facilities, and steps that facilities can take to enhance existing ASP structure and process.
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Infect. Dis. Clin. North Am. · Dec 2017
ReviewAntimicrobial Pharmacokinetics and Pharmacodynamics in Older Adults.
Antimicrobial use in older adults requires working knowledge of the pharmacokinetics and pharmacodynamics of these drugs, and the alterations known to occur with these models as patients age. A summary of pharmacokinetic principles relevant to antimicrobials and an overview of published medical literature describing pharmacokinetic changes known to correlate with age are presented. ⋯ The understanding of how older adults respond in terms of efficacy and toxicity is increasing but limited. Further research into the effects of aging on the actions of antimicrobials in the elderly is needed.