TY - JOUR
T1 - Antibiotic Stewardship for Older Adults in Ambulatory Care Settings
T2 - Addressing an Unmet Challenge
AU - Pulia, Michael S.
AU - Keller, Sara C.
AU - Crnich, Christopher J.
AU - Jump, Robin L.P.
AU - Yoshikawa, Thomas T.
N1 - Funding Information:
This work was supported in part by funds and facilities provided by the Agency for Healthcare Research and Quality (AHRQ) (K08HS024342), The Cleveland Geriatric Research, Education, and Clinical Center, and the Specialty Care Center of Innovation at the VA Northeast Ohio Healthcare System. The findings and conclusions in this document are those of the authors, who are responsible for its content, and do not necessarily represent the views of the AHRQ, the VA, or the US government.
Funding Information:
Michael S. Pulia has served as co‐investigator on a research study funded by Roche. Robin L.P. Jump is the principal investigator on research grants from Pfizer and Accelerate; she has also participated in advisory boards for Pfizer and Merck. None of the other authors have relevant conflicts of interest to disclose.
Funding Information:
This work was supported in part by funds and facilities provided by the Agency for Healthcare Research and Quality (AHRQ) (K08HS024342), The Cleveland Geriatric Research, Education, and Clinical Center, and the Specialty Care Center of Innovation at the VA Northeast Ohio Healthcare System. The findings and conclusions in this document are those of the authors, who are responsible for its content, and do not necessarily represent the views of the AHRQ, the VA, or the US government. Michael S. Pulia has served as co-investigator on a research study funded by Roche. Robin L.P. Jump is the principal investigator on research grants from Pfizer and Accelerate; she has also participated in advisory boards for Pfizer and Merck. None of the other authors have relevant conflicts of interest to disclose. All authors contributed substantively to the content of the manuscript. Not applicable.
Publisher Copyright:
© 2019 The American Geriatrics Society
PY - 2020/2/1
Y1 - 2020/2/1
N2 - 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.
AB - 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.
KW - adverse drug reactions
KW - ambulatory care
KW - antibiotic stewardship
KW - emergency department
KW - infection
UR - http://www.scopus.com/inward/record.url?scp=85075460886&partnerID=8YFLogxK
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U2 - 10.1111/jgs.16256
DO - 10.1111/jgs.16256
M3 - Article
C2 - 31750937
AN - SCOPUS:85075460886
SN - 0002-8614
VL - 68
SP - 244
EP - 249
JO - Journal of the American Geriatrics Society
JF - Journal of the American Geriatrics Society
IS - 2
ER -