Adriana Chadryś, Anna Wiela-Hojeńska

Difficulties of treating bacterial infections in the geriatric population
2021-12-29

Conducting effective and safe treatment of bacterial infections in the geriatric population is associated with many difficulties. They include the heterogeneity of the group in which the lesions overlap with the changes resulting from the aging processes. Their distinction is sometimes difficult and it sometimes happens that some of them remain unrecognized until crisis situations. Elderly people are more likely to develop bacterial infections compared to younger adults. The aging of the immune system, comorbidities, as well as the frequent malnutrition and social determinants of health, such as nursing home care, increase the risk of infections. Older people with diabetes, chronic obstructive pulmonary disease, or heart failure are more prone to common infections while showing a lower response to vaccination than those without health problems. It is also not uncommon for them to activate latent infections.

The morphological and functional changes in the elderly body are also responsible for differentiation pharmacokinetics and pharmacodynamics, and consequently for different drug effects. Therapy must always be balanced between the benefits and adverse effects of drugs. Pharmacotherapy of seniors is characterized by multidrug use, which may cause numerous adverse interactions between concomitantly used drugs as well as drugs and dietary supplements. Adequate adherence is also a factor responsible for optimal pharmacotherapy in the elderly. It may be disturbed by inadequate patient-doctor or patient-pharmacist communication. The ineffectiveness of antibiotic therapy may result from not taking into account the current epidemiological situation of a given region, hospital, or ward. Drugs that do not meet the criteria of evidence-based medicine are selected. Despite many educational activities of the National Antibiotic Protection Program promoting proper knowledge about antibacterial drugs, patients still use antibiotics due to symptoms of a cold. However, the above-mentioned problems can be overcome thanks to comprehensive knowledge and practical skills of medical personnel, awareness of their existence, holistic approach to the patient, and interprofessional cooperation fostered by the provisions of the Act of 10 December 2020 on the Pharmaceutical Profession, especially concerning pharmaceutical care and clinical pharmacy.

Keywords: geriatric population, bacterial infections, drug treatment, adverse effects, interactions.

© Farm Pol, 2021, 77 (11): 670–682