老年患者抗菌药物合理应用刍议CSCD

老年人容易罹患多种疾病,多重用药问题普遍,老年人群的合理用药问题,尤其是抗菌药物的合理应用至关重要。老年人具有独特的生理、病理特征,随增龄而出现的免疫功能减退以及营养不良、基础疾病、黏膜屏障功能减退、咳嗽反射减弱和泌尿系统功能性改变等多种因素均可能导致老年人感染机会增加。针对老年人抗菌药物应用的建议包括严格掌握适应证,谨慎选药;警惕不良药物‐药物相互作用;关注老药新用的安全性;制订个体化给药方案等。抗菌药物的不合理使用,不但增加患者的经济负担,更严重的是直接导致细菌耐药性的产生。临床医师应严格掌握抗菌药物的适应证,尽可能通过监测血药浓度,制定个性化给药方案,重视用药监护,促进老年人群用药安全。

A humble opinion on rational application of anti-bacterial agents in the elderlyCSCD

The elderly are susceptible to a variety of diseases and the problem of multiple medications is common. Therefore, the rational use of medications in the elderly, especially the rational use of anti-bacterial drugs, is very important. The elderly have unique physiological and pathological characteristics. The decrease of immune function with aging and various factors such as malnutrition, primary disease, decreased mucosal barrier function, weakened cough reflex, and functional changes of the urinary tract system may increase the chance of infection in the elderly. Recommendations for the application of antibacterial drugs in the elderly include strictly grasping of the indications and selecting drug carefully, being alert to adverse drug-drug interactions, paying attention to the safety of drugs in new indications, and formulating individualized therapeutic regimen, etc. The irrational use of antibiotics not only increases the economic burden of patients, but also directly leads to the emergence of bacterial resistance. Clinicians should strictly grasp the indications of antibiotics, monitor the blood drug concentration as much as possible, formulate individualized drug administration plan, and pay attention to medication monitoring, so as to promote the medication safety in the elderly. © 2021 Chinese Medical Association