Antibiotic Stewardship for Older Adults in Ambulatory Care Settings: Addressing an Unmet Challenge

被引：15
|
作者：
Pulia, Michael S. [1 ]
Keller, Sara C. [2 ]
Crnich, Christopher J. [3 ,4 ]
Jump, Robin L. P. [5 ,6 ,7 ,8 ]
Yoshikawa, Thomas T. [9 ,10 ,11 ,12 ]
机构：
[1] Univ Wisconsin, BerbeeWalsh Dept Emergency Med, Sch Med & Publ Hlth, Madison, WI USA
[2] Johns Hopkins Univ, Sch Med, Dept Med, Baltimore, MD 21205 USA
[3] Univ Wisconsin, Dept Med, Sch Med & Publ Hlth, Madison, WI USA
[4] William S Middleton Vet Affairs Med Ctr, Madison, WI USA
[5] VA Northeast Ohio Healthcare Syst, Geriatr Res Educ & Clin Ctr, Cleveland, OH USA
[6] VA Northeast Ohio Healthcare Syst, Specialty Care Ctr Innovat, Cleveland, OH USA
[7] Case Western Reserve Univ, Sch Med, Dept Med, Cleveland, OH 44106 USA
[8] Case Western Reserve Univ, Sch Med, Dept Populat & Quantitat Hlth Sci, Cleveland, OH USA
[9] Dept Vet Affairs Greater Los Angeles Healthcare S, Los Angeles, CA USA
[10] Geriatr Res Educ & Clin Ctr, Los Angeles, CA USA
[11] Dept Vet Affairs Greater Los Angeles Healthcare S, Dept Med, Los Angeles, CA USA
[12] Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Los Angeles, CA 90095 USA
来源：
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY | 2020年 / 68卷 / 02期
基金：
美国医疗保健研究与质量局; 美国国家卫生研究院;
关键词：
adverse drug reactions; ambulatory care; antibiotic stewardship; emergency department; infection; ACUTE RESPIRATORY-INFECTIONS; ANTIMICROBIAL STEWARDSHIP; UNITED-STATES; POPULATION; PROVIDER; PATIENT;
D O I：
10.1111/jgs.16256
中图分类号：
R592 [老年病学]; C [社会科学总论];
学科分类号：
03 ; 0303 ; 100203 ;
摘要：
Inappropriate antibiotic use is common in older adults (aged >65 y), and they are particularly vulnerable to serious antibiotic-associated adverse effects such as cardiac arrhythmias, delirium, aortic dissection, drug-drug interactions, and Clostridioides difficile. Antibiotic prescribing improvement efforts in older adults have been primarily focused on inpatient and long-term care settings. However, the ambulatory care setting is where the vast majority of antibiotic prescribing to older adults occurs. To help improve the clinical care of older adults, we review drivers of antibiotic prescribing in this population, explore systems aspects of ambulatory care that can create barriers to optimal antibiotic use, discuss existing stewardship interventions, and provide guidance on priority areas for future inquiry. J Am Geriatr Soc 68:244-249, 2020
引用
收藏
页码：244 / 249
页数：6
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